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General NPI Number Information
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NPI Number | 1184017535
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Entity Type | Organization
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Legal Business Name | KYRILLOS MEDICAL CARE LLC.
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 170 NE 2ND ST # 23
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City | BOCA RATON
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State | FL
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Zip | 33429-5001
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Country | US
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Telephone | 561-322-6547
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Fax |
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Provider Business Mailing Address
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Address Line | 170 NE 2ND ST # 23
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City | BOCA RATON
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State | FL
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Zip | 33429-5001
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Country | US
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Telephone | 561-322-6547
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARA WAHBA
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Credential |
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Telephone | 561-322-6547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME96596
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License Number State | FL
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