Healthcare Provider Details

I. General information

NPI: 1821922832
Provider Name (Legal Business Name): PLASTIC SURGEONS OF BOCA RATON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 380
BOCA RATON FL
33431-6469
US

IV. Provider business mailing address

1279 W PALMETTO PARK RD
BOCA RATON FL
33427-0801
US

V. Phone/Fax

Practice location:
  • Phone: 561-251-0023
  • Fax: 561-393-2445
Mailing address:
  • Phone: 561-251-0023
  • Fax: 561-393-2445

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: DANIEL OHARA
Title or Position: PRESIDENT
Credential: MD
Phone: 561-251-0023