Healthcare Provider Details

I. General information

NPI: 1457384331
Provider Name (Legal Business Name): PAUL D PARE' M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 SE HOSPITAL AVE
STUART FL
34994-2338
US

IV. Provider business mailing address

304 SE HOSPITAL AVE
STUART FL
34994-2338
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-8444
  • Fax: 772-283-8456
Mailing address:
  • Phone: 772-283-8444
  • Fax: 772-283-8456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME54986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: