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General NPI Number Information
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NPI Number | 1154508695
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Entity Type | Organization
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Legal Business Name | BOCA MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1307 W PALMETTO PARK RD
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City | BOCA RATON
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State | FL
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Zip | 33486-3313
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Country | US
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Telephone | 561-368-7430
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Fax | 561-368-7401
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Provider Business Mailing Address
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Address Line | 1307 W PALMETTO PARK RD
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City | BOCA RATON
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State | FL
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Zip | 33486-3313
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Country | US
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Telephone | 561-368-7430
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Fax | 561-368-8224
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Authorized Official
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Title or Position | MGMR
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Name | CARL L ENGLISH
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Credential |
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Telephone | 561-368-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | ORF 113
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1313416
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License Number State | FL
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