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General NPI Number Information
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NPI Number | 1144349671
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Entity Type | Organization
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Legal Business Name | MINKOFFSPORTSOPEDIC ASSOCIATES P.A.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9070 KIMBERLY BLVD STE 24
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City | BOCA RATON
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State | FL
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Zip | 33434-2861
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Country | US
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Telephone | 561-999-9349
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Fax | 561-999-9368
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Provider Business Mailing Address
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Address Line | 9070 KIMBERLY BLVD STE 24
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City | BOCA RATON
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State | FL
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Zip | 33434-2861
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Country | US
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Telephone | 561-999-9349
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Fax | 561-999-9368
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY MINKOFF
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Credential | MD
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Telephone | 561-999-9349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | ME0079507
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License Number State | FL
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