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General NPI Number Information
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NPI Number | 1033809645
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Entity Type | Organization
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Legal Business Name | BOCACARE INC
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 10301 HAGEN RANCH RD STE A940
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3780
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Country | US
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Telephone | 561-736-0070
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Fax | 561-736-7476
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Provider Business Mailing Address
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Address Line | 1001 NW 13TH ST STE 201
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City | BOCA RATON
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State | FL
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Zip | 33486-2269
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MARCELLA GRAVALESE
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Credential |
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Telephone | 954-665-7342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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