Organization
BRUCE H PALEY PA
Active
Organization
BRUCE H PALEY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE HENRY PALEY DO (PRESIDENT OF PA)
(904) 824-8088
Entity
Organization
Contact information
Practice address
1851 OLD MOULTRIE RD, SUITE B, ST AUGUSTINE, FL 32084-4168
(904) 824-8088
(904) 826-4105
Mailing address
1851 OLD MOULTRIE RD, SUITE B, ST AUGUSTINE, FL 32084-4168
(904) 824-8088
(904) 826-4105
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS5622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070005035
RAILROAD MEDICARE
—
01
—
101894
AVMED
—
05
—
371938300
—
FL
01
—
4394237
AETNA
—
01
—
80532
BLUE CROSS
—
Enumeration date
08/04/2014
Last updated
08/04/2014
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