MEDICARE: JOSE R. NODARSE MD, P.L.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1154551836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE R. NODARSE MD, P.L.

Provider Business Mailing Address
First Line	:	1495 FOREST HILL BLVD
Second Line	:	SUITE D
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	561-651-9056
Fax Number	:	561-651-9059

Provider Business Practice Location Address
First Line	:	1495 FOREST HILL BLVD
Second Line	:	SUITE D
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	561-651-9056
Fax Number	:	561-651-9059

Authorized Official
Title or Position	:	OWNER
Name	:	JOSE R. NODARSE
Credential	:	MD
Telephone Number	:	305-905-6856

Provider Enumeration Date	:	07/16/2009
Last Update Date	:	12/11/2013

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