Healthcare Provider Details

I. General information

NPI: 1831007632
Provider Name (Legal Business Name): RIMMA TETELBOIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22186 CLOCKTOWER WAY
BOCA RATON FL
33428-4640
US

IV. Provider business mailing address

22186 CLOCKTOWER WAY
BOCA RATON FL
33428-4640
US

V. Phone/Fax

Practice location:
  • Phone: 561-322-0905
  • Fax:
Mailing address:
  • Phone: 561-322-0905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9201961
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: