Healthcare Provider Details

I. General information

NPI: 1972382976
Provider Name (Legal Business Name): DR BENJAMIN SOFFER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 12/17/2023
Certification Date: 12/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 CLINT MOORE RD # 5060
BOCA RATON FL
33496-2041
US

IV. Provider business mailing address

2901 CLINT MOORE RD # 5060
BOCA RATON FL
33496-2041
US

V. Phone/Fax

Practice location:
  • Phone: 561-468-6981
  • Fax: 561-709-4606
Mailing address:
  • Phone: 561-468-6981
  • Fax: 561-709-4606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN SOFFER
Title or Position: OWNER
Credential: DO
Phone: 561-468-6981