Healthcare Provider Details

I. General information

NPI: 1588302624
Provider Name (Legal Business Name): SIGNATURE MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3196 N FEDERAL HWY
BOCA RATON FL
33431-6700
US

IV. Provider business mailing address

3196 N FEDERAL HWY
BOCA RATON FL
33431-6700
US

V. Phone/Fax

Practice location:
  • Phone: 561-418-2505
  • Fax: 855-948-4128
Mailing address:
  • Phone: 561-418-2505
  • Fax: 855-948-4128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE THOMAS
Title or Position: PRESIDENT & CEO
Credential: DHA, FACHE
Phone: 561-418-2505