Provider Demographics
NPI:1831299767
Name:STOESSEL, RUEL TYRONE (MD)
Entity type:Individual
Prefix:DR
First Name:RUEL
Middle Name:TYRONE
Last Name:STOESSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:2700 PGA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2958
Practice Address - Country:US
Practice Address - Phone:561-630-8001
Practice Address - Fax:561-630-8007
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72366207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253207700Medicaid
FLF21259Medicare UPIN
FL42432Medicare ID - Type Unspecified