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General NPI Number Information
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NPI Number | 1295832640
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Entity Type | Organization
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Legal Business Name | PALM WEST INTERNISTS PA
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 13005 SOUTHERN BLVD SUITE 241
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9206
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Country | US
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Telephone | 561-790-5666
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Fax | 561-790-5668
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Provider Business Mailing Address
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Address Line | 13005 SOUTHERN BLVD SUITE 241
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9206
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Country | US
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Telephone | 561-790-5666
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Fax | 561-790-5668
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANAIS HERNANDEZ
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Credential |
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Telephone | 561-790-5666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0041459
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License Number State | FL
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