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Organization
OBSIDIAN HEALTHCARE LLC
Active
Organization
OBSIDIAN HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUDE ACLOQUE MD (AUTHORIZED OFFICIAL)
(561) 443-0066
Entity
Organization
Contact information
Practice address
3379 W WOOLBRIGHT RD, BOYNTON BEACH, FL 33436-7245
(561) 449-0066
(561) 834-2511
Mailing address
3379 W WOOLBRIGHT RD, BOYNTON BEACH, FL 33436-7245
(561) 449-0066
(561) 834-2511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME133297
LICENSE
FL
Enumeration date
02/17/2023
Last updated
02/17/2023
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