Healthcare Provider Details

I. General information

NPI: 1609164375
Provider Name (Legal Business Name): JBS MED PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5503 N FEDERAL HWY
BOCA RATON FL
33487-4043
US

IV. Provider business mailing address

5503 N FEDERAL HWY
BOCA RATON FL
33487-4043
US

V. Phone/Fax

Practice location:
  • Phone: 561-393-8800
  • Fax: 561-393-6202
Mailing address:
  • Phone: 561-393-8800
  • Fax: 561-393-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW H ROSENTHAL
Title or Position: OWNER
Credential: MD
Phone: 561-393-8800