Healthcare Provider Details

I. General information

NPI: 1285685586
Provider Name (Legal Business Name): BOCA RATON AMBULATORY ANESTHESIA SERVICES II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 LINTON BLVD BLDG B
DELRAY BEACH FL
33445-6584
US

IV. Provider business mailing address

40 NE 2ND AVE
DEERFIELD BEACH FL
33441-3504
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-9111
  • Fax: 561-495-6766
Mailing address:
  • Phone: 954-426-8840
  • Fax: 954-426-6642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. EVELYN FISCALETTI
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 954-426-8840