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General NPI Number Information
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NPI Number | 1134144710
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Entity Type | Organization
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Legal Business Name | PALMS WEST OB-GYN ASSOCIATES PA
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 12953 PALMS WEST DR SUITE 101 BLDG 6
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4990
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Country | US
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Telephone | 561-795-2400
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Fax | 561-795-6813
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Provider Business Mailing Address
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Address Line | 12953 PALMS WEST DR SUITE 101 BLDG 6
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4990
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Country | US
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Telephone | 561-795-2400
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Fax | 561-795-6813
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUL CARLOS VALDESCRUZ
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Credential | MD
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Telephone | 561-795-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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