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General NPI Number Information
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NPI Number | 1114190956
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Entity Type | Organization
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Legal Business Name | PETER J RECUPERO DO PA
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 04/11/2008
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Provider Practice Location Address
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Address Line | 801 MEADOWS RD SUITE 120
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City | BOCA RATON
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State | FL
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Zip | 33486-2346
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Country | US
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Telephone | 561-239-6494
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Fax | 561-526-1081
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Provider Business Mailing Address
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Address Line | 801 MEADOWS RD SUITE 120
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City | BOCA RATON
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State | FL
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Zip | 33486-2346
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Country | US
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Telephone | 561-239-6494
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Fax | 561-526-1081
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER RECUPERO
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Credential | DO
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Telephone | 561-239-6494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | OS9238
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License Number State | FL
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