Healthcare Provider Details

I. General information

NPI: 1790009710
Provider Name (Legal Business Name): SECKLER HEART CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 200
BOCA RATON FL
33431-6465
US

IV. Provider business mailing address

660 GLADES RD STE 200
BOCA RATON FL
33431-6465
US

V. Phone/Fax

Practice location:
  • Phone: 561-338-9992
  • Fax: 561-338-7771
Mailing address:
  • Phone: 561-338-9992
  • Fax: 561-338-7771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME 75658
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME 75658
License Number StateFL

VIII. Authorized Official

Name: DR. JONATHAN I SECKLER
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 561-338-9992