Provider Demographics
NPI:1912235953
Name:PALM SPRINGS MEDICAL SERVICES
Entity Type:Organization
Organization Name:PALM SPRINGS MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GARCIA-SEPTIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-430-2240
Mailing Address - Street 1:12600 PEMBROKE RD
Mailing Address - Street 2:SUITE-300
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2544
Mailing Address - Country:US
Mailing Address - Phone:954-430-2240
Mailing Address - Fax:954-430-2241
Practice Address - Street 1:12600 PEMBROKE RD
Practice Address - Street 2:SUITE-300
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2544
Practice Address - Country:US
Practice Address - Phone:954-430-2240
Practice Address - Fax:954-430-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044890261QH0100X
FLMEOO44890261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069640401Medicaid
FLBG4218409OtherDEA
FLBG4218409OtherDEA