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General NPI Number Information
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NPI Number | 1205316585
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Entity Type | Organization
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Legal Business Name | SPECIALITY AT PAUL G. PRESTE MD & ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 3075 E COMMERCIAL BLVD SUITE 1A
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308
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Country | US
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Telephone | 954-491-6200
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Fax | 954-491-6419
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Provider Business Mailing Address
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Address Line | 3075 E COMMERCIAL BLVD STE 1A
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4318
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Country | US
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Telephone | 954-491-6200
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Fax | 954-491-6419
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DONNA GOLDEN
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Credential |
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Telephone | 954-491-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME134189
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License Number State | FL
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