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General NPI Number Information
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NPI Number | 1336817592
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Entity Type | Organization
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Legal Business Name | RUEL T STOESSEL MD PA
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 1800 SE TIFFANY AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7521
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Country | US
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Telephone | 772-335-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 8645 N MILITARY TRL STE 508
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6296
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Country | US
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Telephone | 561-630-8001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RUEL TYRONE STOESSEL
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Credential | MD
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Telephone | 561-630-8001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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