Provider Demographics
NPI:1568731701
Name:OBGYN HEALTHCARE FOR WOMEN
Entity Type:Organization
Organization Name:OBGYN HEALTHCARE FOR WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:STOESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-737-7400
Mailing Address - Street 1:2828 S SEACREST BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7944
Mailing Address - Country:US
Mailing Address - Phone:561-737-7400
Mailing Address - Fax:
Practice Address - Street 1:2828 S SEACREST BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7944
Practice Address - Country:US
Practice Address - Phone:561-737-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072366174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty