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General NPI Number Information
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NPI Number | 1104933084
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Entity Type | Organization
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Legal Business Name | BOCA RATON ORTHOPEDIC GROUP INC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 660 GLADES RD SUITE 460
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City | BOCA RATON
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State | FL
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Zip | 33431-6465
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Country | US
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Telephone | 561-391-5515
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Fax | 561-347-7470
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Provider Business Mailing Address
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Address Line | 660 GLADES RD SUITE 460
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City | BOCA RATON
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State | FL
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Zip | 33431-6465
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Country | US
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Telephone | 561-391-5515
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Fax | 561-347-7470
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Authorized Official
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Title or Position | CEO
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Name | JOHN EDWARD HORNBERGER
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Credential |
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Telephone | 561-391-5515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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