OrganizationActive
Premium Medical Center Corp
NPI 1053971937 · Clinic/Center · Virginia Gardens, FL
Provider details
- NPI number
- 1053971937
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Deivys Gonzalez Oliva, Authorized Official(786) 334-5047
Specialties & taxonomies
Ambulatory Health Care Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6405 Nw 36th St Ste 111
Virginia Gardens, FL 33166-6977
Phone: (786) 334-5047
Fax: (786) 334-5048
Street-level locationGet directions
Mailing address
6405 Nw 36th St Ste 111
Virginia Gardens, FL 33166-6977
Registry dates
- Enumerated
- 2019-06-13
- Last updated
- 2025-01-14
- Certified
- 2025-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.