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General NPI Number Information
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NPI Number | 1093728214
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Entity Type | Organization
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Legal Business Name | BOCA RATON PHYSICIANS PA
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 1905 CLINT MOORE RD STE 201
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City | BOCA RATON
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State | FL
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Zip | 33496-2660
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Country | US
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Telephone | 561-994-5454
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Fax | 561-994-8873
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Provider Business Mailing Address
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Address Line | 1905 CLINT MOORE RD STE 201
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City | BOCA RATON
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State | FL
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Zip | 33496-2660
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Country | US
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Telephone | 561-994-5454
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Fax | 561-994-8873
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KEISHA MCDONNOUGH
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Credential |
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Telephone | 561-994-5454
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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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