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General NPI Number Information
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NPI Number | 1750039863
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Entity Type | Organization
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Legal Business Name | RONOEL PENALVER MDPA
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 10081 PINES BLVD STE B
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City | PEMBROKE PNES
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State | FL
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Zip | 33024-6171
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Country | US
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Telephone | 954-251-1175
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Fax | 954-842-3332
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Provider Business Mailing Address
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Address Line | 4581 WESTON RD STE 381
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City | WESTON
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State | FL
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Zip | 33331-3141
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Country | US
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Telephone | 954-251-1175
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Fax | 954-842-3332
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Authorized Official
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Title or Position | MD/OWNER
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Name | RONOEL PENALVER
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Credential | MD
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Telephone | 954-852-5485
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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 |
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License Number State |
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