Healthcare Provider Details

I. General information

NPI: 1952471104
Provider Name (Legal Business Name): BOYNTON BEACH HEART CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 W BOYNTON BEACH BLVD STE 102
BOYNTON BEACH FL
33436
US

IV. Provider business mailing address

3925 W BOYNTON BEACH BLVD STE 102
BOYNTON BEACH FL
33436
US

V. Phone/Fax

Practice location:
  • Phone: 561-735-3334
  • Fax: 561-735-3774
Mailing address:
  • Phone: 561-735-3334
  • Fax: 561-735-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME89000
License Number StateFL

VIII. Authorized Official

Name: DR. SAMEH YOUSSEF
Title or Position: PRESIDENT
Credential: MD
Phone: 561-735-3334