OrganizationActive
Premium Primary Care & Walk-In Clinic Inc
NPI 1700654167 · Family Medicine Physician · Port St Lucie, FL
Provider details
- NPI number
- 1700654167
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Patrick Vergel De Dios, Aprn(772) 446-0950
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
1801 Se Hillmoor Dr Unit A-107p
Port St Lucie, FL 34952-7553
Phone: (772) 446-0950
Fax: (772) 446-0956
Street-level locationGet directions
Mailing address
1801 Se Hillmoor Dr Unit A-107p
Port St Lucie, FL 34952-7553
Registry dates
- Enumerated
- 2023-12-15
- Last updated
- 2023-12-15
- Certified
- 2023-12-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.