Healthcare Provider Details

I. General information

NPI: 1326056789
Provider Name (Legal Business Name): BOCA RATON PEDIATRIC ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 NW 13TH ST SUITE 5D
BOCA RATON FL
33486-2359
US

IV. Provider business mailing address

951 NW 13TH ST SUITE 5D
BOCA RATON FL
33486-2359
US

V. Phone/Fax

Practice location:
  • Phone: 561-392-7266
  • Fax:
Mailing address:
  • Phone: 561-392-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JERRY ROBERT WEXLER
Title or Position: PRESIDENT
Credential: MD
Phone: 561-392-7266