JUAN PREMOLI (NPI# 1053375584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053375584 |
| Entity Type | Individual |
| Full Name | JUAN PREMOLI |
| Credential | M.D. |
| Practice Address |
21150 Biscayne Blvd 404 Aventura FL 33180-1226 |
| Mailing Address |
2234 Colonial Blvd Managed Care Dept Fort Myers FL 33907-1412 |
| Practice Telephone | 3054669111 |
| Practice Fax Number | 3054669127 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2017-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME87618 | FL | Other Service Providers |
| Y | 208800000X | Urology | ME87618 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS FL | 81710 | 01 |
| FL | 275037600 | 05 | |
| FL | RR MEDICARE PTAN | P00721043 | 01 |
| FL | WELLCARE | 240750 | 01 |
| FL | SIMPLY HEALTHCARE | P01720865 | 01 |
| FL | AETNA PROVIDER # | 7845484 | 01 |
| FL | MOLINA | QMP000003854191 | 01 |
| FL | FLORIDA HEALTHCARE PLUS | P0003165 | 01 |
| Street Address |
21150 BISCAYNE BLVD 404 |
| City | AVENTURA |
| State | FL |
| Zip Code | 33180-1226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596098 | Marvin Diaz-lacayo | Specialist | 21150 Biscayne Blvd, Ste 101, Aventura, FL 33180-1226 | 2005-05-23 |
| 1639621972 | Joanna Dinan | Nurse Practitioner | 21150 Biscayne Blvd, Aventura, FL 33180 | 2016-11-03 |
| 1881053304 | Denise Frances Rivera | Nurse Practitioner | 21150 Biscayne Blvd, Aventura, FL 33180-1226 | 2016-02-11 |
| 1801253695 | Spine Specialists of South Florida LLC | Durable Medical Equipment & Medical Supplies | 21150 Biscayne Blvd, Ste 101, Aventura, FL 33180-1226 | 2016-01-25 |
| 1821476896 | Urocare-all LLC | Specialist | 21150 Biscayne Blvd, Suite 404, Aventura, FL 33180-1226 | 2015-05-11 |
| 1265861504 | Margaret Mcknight | Physician Assistant | 21150 Biscayne Blvd, Suite 400, Aventura, FL 33180-1226 | 2013-11-07 |
| 1538405857 | Ivette Cardelli | Nurse Practitioner | 21150 Biscayne Blvd, Suite 106, Aventura, FL 33180-1226 | 2012-12-13 |
| 1891074746 | Dina Rachel Edrich | Family Medicine | 21150 Biscayne Blvd, Suite 302, Aventura, FL 33180-1226 | 2011-08-10 |
| 1588953681 | Hj Richman Dds, Pa | Dentist | 21150 Biscayne Blvd, Suite 401, Aventura, FL 33180-1226 | 2011-03-30 |
| 1497054332 | Carlista Jones | Licensed Practical Nurse | 21150 Biscayne Blvd, Suite 400, Aventura, FL 33180-1226 | 2011-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607849 | Nabeel Rahman Khan | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Boulevard, Avetura, Fl, Aventura, FL 33180 | 2020-04-09 |
| 1235766841 | Hanny Hausmann | Counselor | 2999 Ne 191 Street, Suite 902, Aventura, FL 33180 | 2020-03-24 |
| 1760976369 | Michael Ernest Molino | Optometrist | 19575 Biscayne Blvd Ste 579, Aventura, FL 33180 | 2018-06-18 |
| 1932602620 | Carmen Somarriba | Physician Assistant | 21110 Biscayne Blvd Bldg Suite400, Aventura, FL 33180 | 2018-03-09 |
| 1235631474 | Premier Florida Podiatry, Pa | Podiatrist | 3060 Ne 190th St Apt 202, Aventura, FL 33180 | 2018-03-04 |
| 1891229126 | Ifrah Zahid Butt | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd., Aventura, FL 33180 | 2017-04-13 |
| 1629500129 | Hector Hugo Gonzalez | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd, South Tower, #807, Aventura Hospital and Medical Center, Aventura, FL 33180 | 2017-04-03 |
| 1457892671 | Nusen Beer | Internal Medicine | 20200 W Dixie Hwy Ste 701, Aventura, FL 33180 | 2017-03-20 |
| 1073052338 | Alfa Diagnostic LLC | Point of Service | 21355 E Dixie Hwy Ste 101, Aventura, FL 33180 | 2017-02-20 |
| 1598211740 | Katherine Mendez-martinez | Nurse Practitioner | 2925 Aventura Blvd. Suite 101, Aventura, FL 33180 | 2016-08-28 |
| Find all providers in zip 33180 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063568491 | Jonathan L Silberstein | Urology | 20801 Biscayne Blvd Ste 203, Aventura, FL 33180-1422 | 2007-01-26 |
| 1427130020 | Arnon Krongrad | Urology | 20900 Ne 30th Ave, Suite 207, Aventura, FL 33180-2100 | 2006-10-20 |
| 1982633558 | Mark S Soloway | Urology | 20801 Biscayne Blvd, Suite 203, Aventura, FL 33180 | 2006-07-03 |
| 1942280706 | Norman Arthur Bloom | Urology | 21097 Ne 27 Ct Suite 101, Aventura, FL 33180 | 2006-01-18 |
| 1841279296 | Urodocs Inc | Urology | 21355 E Dixie Hwy Ste 102, Aventura, FL 33180-1239 | 2006-01-13 |
| 1952387102 | Dade Broward Urology LLC | Urology | 21110 Biscayne Boulevard, Suite 401, Aventura, FL 33180 | 2005-12-20 |
| 1023010808 | Giridhar S Talluri | Urology | 21110 Biscayne Blvd Ste 403, Aventura, FL 33180-1252 | 2005-08-11 |
| 1427426113 | Genesiscare Usa of Florida LLC | Urology | 21110 Biscayne Blvd, Suite 401, Aventura, FL 33180-1227 | 2015-09-11 |
| 1093132169 | South Broward Hospital District | Urology | 20801 Biscayne Blvd, Suite 203, Aventura, FL 33180-1430 | 2014-03-26 |
| 1851652531 | Arnon Krongrad, M.d., P.a. | Urology | 20900 Ne 30th Ave, Ste 207, Aventura, FL 33180-2100 | 2012-05-30 |
| Find all providers in AVENTURA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.