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General NPI Number Information
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NPI Number | 1225445174
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Entity Type | Organization
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Legal Business Name | BOCA BABES OBGYN, LLC
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 1880 N. CONGRESS AVE SUITE 320
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City | BOYNTON BEACH
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State | FL
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Zip | 33426
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Country | US
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Telephone | 561-702-1329
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Fax | 888-734-6559
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Provider Business Mailing Address
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Address Line | 1880 N. CONGRESS AVE SUITE 320
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City | BOYNTON BEACH
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State | FL
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Zip | 33426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | TY SWARTZLANDER
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Credential | M.D.
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Telephone | 561-702-1329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME116051
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License Number State | FL
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