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General NPI Number Information
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NPI Number | 1336383371
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Entity Type | Organization
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Legal Business Name | LEDESMA MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 1892 ABBEY RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-5688
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Country | US
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Telephone | 561-429-6133
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Fax | 561-429-6134
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Provider Business Mailing Address
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Address Line | 1892 ABBEY RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-5688
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Country | US
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Telephone | 561-429-6133
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Fax | 561-429-6134
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARCOS LEDESMA
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Credential | MASSAGE THERAPIST
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Telephone | 561-429-6134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA 44953
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License Number State | FL
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