Provider Demographics
NPI:1710126537
Name:PREMIER ASSOCIATES FOR THE HEALTHCARE OF WOMEN LLC
Entity type:Organization
Organization Name:PREMIER ASSOCIATES FOR THE HEALTHCARE OF WOMEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUEL
Authorized Official - Middle Name:TYRONE
Authorized Official - Last Name:STOESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:561-630-8001
Mailing Address - Street 1:2700 PGA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2958
Mailing Address - Country:US
Mailing Address - Phone:561-630-8001
Mailing Address - Fax:561-630-8007
Practice Address - Street 1:232 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3426
Practice Address - Country:US
Practice Address - Phone:561-996-9573
Practice Address - Fax:855-808-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty