Healthcare Provider Details

I. General information

NPI: 1669521241
Provider Name (Legal Business Name): PREMIER CARDIOLOGY OF BOCA RATON LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NW 9TH CT SUITE 201
BOCA RATON FL
33486-2268
US

IV. Provider business mailing address

1000 NW 9TH CT SUITE 201
BOCA RATON FL
33486-2268
US

V. Phone/Fax

Practice location:
  • Phone: 561-395-4600
  • Fax: 561-395-6903
Mailing address:
  • Phone: 561-395-4600
  • Fax: 561-395-6903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ADRIA J MAURER
Title or Position: OFFICE MANAGER
Credential:
Phone: 561-395-4600