MEDICARE: PALM SPRINGS MEDICAL SERVICES INC

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	208D00000X	General Practice Physician	ME0044890	FL

General Provider Information

NPI Number	:	1376769240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM SPRINGS MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	12133 PEMBROKE RD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-1727
Country	:	US
Telephone Number	:	954-430-2242
Fax Number	:	954-430-2241

Provider Business Practice Location Address
First Line	:	12133 PEMBROKE RD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-1727
Country	:	US
Telephone Number	:	954-430-2242
Fax Number	:	954-430-2241

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAMON M GARCIA-SEPTIEN
Credential	:	M.D
Telephone Number	:	954-430-2240

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/22/2020

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