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General NPI Number Information
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NPI Number | 1568731701
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Entity Type | Organization
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Legal Business Name | OBGYN HEALTHCARE FOR WOMEN
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Dates
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Enumeration Date | 12/16/2011
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 2828 S SEACREST BLVD STE 201
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7944
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Country | US
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Telephone | 561-737-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 2828 S SEACREST BLVD STE 201
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7944
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Country | US
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Telephone | 561-737-7400
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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 T STOESSEL
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Credential | MD
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Telephone | 561-737-7400
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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 | ME0072366
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License Number State | FL
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