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General NPI Number Information
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NPI Number | 1336246917
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Entity Type | Organization
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Legal Business Name | WEST BOCA FAMILY MEDICAL ASSOCIATES PA
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 9970 CENTRAL PARK BLVD N SUITE 205
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City | BOCA RATON
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State | FL
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Zip | 33428-2236
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Country | US
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Telephone | 561-487-1203
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Fax | 561-487-1251
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Provider Business Mailing Address
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Address Line | 9970 CENTRAL PARK BLVD N SUITE 205
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City | BOCA RATON
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State | FL
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Zip | 33428-2236
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Country | US
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Telephone | 561-487-1203
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Fax | 561-487-1251
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL C DIAMOND
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Credential | D.O
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Telephone | 561-487-1203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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