Provider Demographics
NPI:1598557233
Name:PREMIER PSYCHIATRIC AND PRIMARY HEALTHCARE
Entity type:Organization
Organization Name:PREMIER PSYCHIATRIC AND PRIMARY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:407-987-3933
Mailing Address - Street 1:2582 MAGUIRE RD STE 224
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4749
Mailing Address - Country:US
Mailing Address - Phone:407-987-3933
Mailing Address - Fax:407-987-3933
Practice Address - Street 1:9305 OGLETHORPE DR
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-7909
Practice Address - Country:US
Practice Address - Phone:407-987-3933
Practice Address - Fax:407-987-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily