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Contact Information

JUAN PREMOLI, MD
21150 BISCAYNE BLVD
404
AVENTURA, FL33180-1226
 Phone: 305-466-9111
 Fax: 305-466-9127
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for JUAN PREMOLI · (Male)

NPI Number 1053375584
Status Active
Credentials MD
Entity Individual
Enumeration date 04/13/2006
Last updated 04/10/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME87618
  • FL Medicaid 275037600
  • FL Other 7845484 AETNA PROVIDER #
  • FL Other 81710 BCBS FL
  • FL Other P0003165 FLORIDA HEALTHCARE PLUS
  • FL Other QMP000003854191 MOLINA
  • FL Other P00721043 RR MEDICARE PTAN
  • FL Other P01720865 SIMPLY HEALTHCARE
  • FL Other 240750 WELLCARE
Hospital affiliation(s)
  • AVENTURA HOSPITAL AND MEDICAL CENTER - (Acute Care)
    20900 BISCAYNE BLVD
    AVENTURA, FL 33180
  • MEMORIAL HOSPITAL WEST - (Acute Care)
    703 N FLAMINGO RD
    PEMBROKE PINES, FL 33028
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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