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General NPI Number Information
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NPI Number | 1013674183
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Entity Type | Organization
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Legal Business Name | BOCA VALLEY MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 7491 N FEDERAL HWY STE C11
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City | BOCA RATON
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State | FL
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Zip | 33487-1688
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Country | US
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Telephone | 561-680-2030
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Fax | 561-680-2299
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Provider Business Mailing Address
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Address Line | 1712 E 16TH ST
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City | BROOKLYN
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State | NY
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Zip | 11229-2926
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Country | US
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Telephone | 917-952-5030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN RAFAEL
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Credential |
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Telephone | 917-952-5030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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