Palm Beach Medical Clinic Llc | |
9123 N Military Trl Suite 102 West Palm Beach FL 33410-5990 | |
(561) 630-9339 | |
Not Available |
Full Name | Palm Beach Medical Clinic Llc |
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Speciality | Internal Medicine |
Location | 9123 N Military Trl, West Palm Beach, Florida |
Authorized Official Name and Position | Stephen Kwashie Woyome (CHIEF EXECUTIVE OFFICER OWNER) |
Authorized Official Contact | 5615844142 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Palm Beach Medical Clinic Llc 13833 Wellington Trce E4-#204 Wellington FL 33414-2116 Ph: (561) 584-4142 | Palm Beach Medical Clinic Llc 9123 N Military Trl Suite 102 West Palm Beach FL 33410-5990 Ph: (561) 630-9339 |
NPI Number | 1710183744 |
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Provider Enumeration Date | 06/26/2007 |
Last Update Date | 05/15/2008 |
Medicare PECOS PAC ID | 1850472762 |
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Medicare Enrollment ID | O20080117000088 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710183744 | NPI | - | NPPES |
AH265 | Other | FL | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME9587 (Florida) | Primary |
Provider Name | Stephen K Woyome |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1750484077 PECOS PAC ID: 5395745996 Enrollment ID: I20070104000426 |
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