Healthcare Provider Details

I. General information

NPI: 1295972834
Provider Name (Legal Business Name): JEFFREY R WARD MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 01/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11834 VALENCIA GARDENS AVE
PALM BEACH GARDENS FL
33410-2933
US

IV. Provider business mailing address

11834 VALENCIA GARDENS AVE
PALM BEACH GARDENS FL
33410-2933
US

V. Phone/Fax

Practice location:
  • Phone: 561-723-5564
  • Fax:
Mailing address:
  • Phone: 561-723-5564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME99403
License Number StateFL

VIII. Authorized Official

Name: DR. JEFFREY WARD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-723-5564