Healthcare Provider Details

I. General information

NPI: 1831299767
Provider Name (Legal Business Name): RUEL TYRONE STOESSEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 PGA BLVD STE 103
PALM BEACH GARDENS FL
33410-2958
US

IV. Provider business mailing address

2700 PGA BLVD STE 103
PALM BEACH GARDENS FL
33410-2958
US

V. Phone/Fax

Practice location:
  • Phone: 561-630-8001
  • Fax: 561-630-8007
Mailing address:
  • Phone: 561-630-8001
  • Fax: 561-630-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberME72366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: