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General NPI Number Information
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NPI Number | 1902767189
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Entity Type | Organization
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Legal Business Name | PALM
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 2701 PGA BLVD STE C
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2982
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Country | US
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Telephone | 561-214-0647
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 PGA BLVD STE C
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2982
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | JILL F RODILA
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Credential | MD
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Telephone | 561-214-0647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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