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Organization
PALM BEACH MEDICAL CLINIC LLC
Active
Organization
PALM BEACH MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN KWASHIE WOYOME M.D., (CHIEF EXECUTIVE OFFICER OWNER)
(561) 584-4142
Entity
Organization
Contact information
Practice address
9123 N MILITARY TRL, SUITE 102, WEST PALM BEACH, FL 33410-5990
(561) 630-9339
Mailing address
13833 WELLINGTON TRCE, E4-#204, WELLINGTON, FL 33414-2116
(561) 584-4142
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME9587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH265
MEDICARE PTAN
FL
Enumeration date
06/26/2007
Last updated
05/15/2008
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