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General NPI Number Information
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NPI Number | 1265810477
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Entity Type | Organization
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Legal Business Name | CITRIN MEDICAL CORP.
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 2061 NW BOCA RATON BLVD STE 106
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City | BOCA RATON
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State | FL
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Zip | 33431
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Country | US
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Telephone | 561-303-2912
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Fax | 561-303-2951
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Provider Business Mailing Address
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Address Line | 2061 NW BOCA RATON BLVD STE106
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City | BOCA RATON
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State | FL
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Zip | 33431
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Country | US
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Telephone | 561-303-2912
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Fax | 561-303-2951
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAX CITRIN
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Credential | DO
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Telephone | 561-303-2912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS12975
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License Number State | FL
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