Healthcare Provider Details

I. General information

NPI: 1447372099
Provider Name (Legal Business Name): BOCA GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9945 CENTRAL PARK BLVD N
BOCA RATON FL
33428-1745
US

IV. Provider business mailing address

9945 CENTRAL PARK BLVD N
BOCA RATON FL
33428-1745
US

V. Phone/Fax

Practice location:
  • Phone: 561-483-0498
  • Fax: 561-483-2982
Mailing address:
  • Phone: 561-483-0498
  • Fax: 561-483-2982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF 1343096
License Number StateFL

VIII. Authorized Official

Name: KARIN DIPIERO
Title or Position: ADMINISTRATOR
Credential:
Phone: 561-483-0498