Healthcare Provider Details

I. General information

NPI: 1104111368
Provider Name (Legal Business Name): SEM BILLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11085 SACCO DR
BOCA RATON FL
33428-3940
US

IV. Provider business mailing address

11085 SACCO DR
BOCA RATON FL
33428-3940
US

V. Phone/Fax

Practice location:
  • Phone: 561-445-9462
  • Fax: 561-883-7175
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN E. MCNALLY SR.
Title or Position: CEO
Credential:
Phone: 561-445-9462