Healthcare Provider Details

I. General information

NPI: 1801180708
Provider Name (Legal Business Name): LUIS A. BOBEICA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16244 S MILITARY TRL STE 220
DELRAY BEACH FL
33484-6505
US

IV. Provider business mailing address

16244 S MILITARY TRL STE 220
DELRAY BEACH FL
33484-6505
US

V. Phone/Fax

Practice location:
  • Phone: 561-404-1022
  • Fax: 561-404-1566
Mailing address:
  • Phone: 561-404-1022
  • Fax: 561-404-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS ANTONIO BOBEICA
Title or Position: PRESIDENT
Credential: MD
Phone: 561-404-1022