Individual
BRUCE HENRY PALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
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
05
—
024544400
—
FL
01
—
0709348001
CIGNA
—
01
—
0898894
AETNA
FL
01
—
101894
AVMED
—
05
—
317938300
—
FL
01
—
4394237
AETNA
—
01
—
593157956
HUMANA
—
01
—
80532
BLUE CROSS
FL
01
—
80532
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/14/2006
Last updated
03/11/2020
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