Healthcare Provider Details

I. General information

NPI: 1669790390
Provider Name (Legal Business Name): PAUL B WIZMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9960 CENTRAL PARK BLVD N SUITE 235
BOCA RATON FL
33428
US

IV. Provider business mailing address

9960 CENTRAL PARK BLVD N SUITE 235
BOCA RATON FL
33428
US

V. Phone/Fax

Practice location:
  • Phone: 954-969-1355
  • Fax: 954-969-1232
Mailing address:
  • Phone: 954-969-1355
  • Fax: 954-969-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME70211
License Number StateFL

VIII. Authorized Official

Name: DR. PAUL B WIZMAN MD
Title or Position: PRESIDENT
Credential: MD
Phone: 954-802-2212