Healthcare Provider Details

I. General information

NPI: 1730723586
Provider Name (Legal Business Name): BOCA SURGERY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 NE 6TH ST UNIT 525
FORT LAUDERDALE FL
33304-6412
US

IV. Provider business mailing address

408 NE 6TH ST UNIT 525
FORT LAUDERDALE FL
33304-6412
US

V. Phone/Fax

Practice location:
  • Phone: 786-853-1470
  • Fax:
Mailing address:
  • Phone: 786-853-1470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State

VIII. Authorized Official

Name: RONALDO VALENCIA
Title or Position: CONSULTANT
Credential:
Phone: 786-853-1470