Healthcare Provider Details

I. General information

NPI: 1710024708
Provider Name (Legal Business Name): PAMELA J LOFTUS MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 01/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 13TH ST STE 103
BOCA RATON FL
33486-2350
US

IV. Provider business mailing address

900 NW 13TH ST STE 103
BOCA RATON FL
33486-2350
US

V. Phone/Fax

Practice location:
  • Phone: 561-394-7494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: PAMELA LOFTUS
Title or Position: PRESIDENT
Credential: MD
Phone: 561-394-7494