Healthcare Provider Details
I. General information
NPI: 1710126537
Provider Name (Legal Business Name): PREMIER ASSOCIATES FOR THE HEALTHCARE OF WOMEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/18/2009
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
232 S MAIN ST
BELLE GLADE FL
33430-3426
US
IV. Provider business mailing address
2700 PGA BLVD STE 103
PALM BEACH GARDENS FL
33410-2958
US
V. Phone/Fax
- Phone: 561-996-9573
- Fax: 855-808-3992
- Phone: 561-630-8001
- Fax: 561-630-8007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RUEL
TYRONE
STOESSEL
Title or Position: OWNER
Credential: MD,PA
Phone: 561-630-8001