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General NPI Number Information
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NPI Number | 1386790939
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Entity Type | Organization
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Legal Business Name | MARC E BOSEM MD PA
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 2300 N COMMERCE PKWY STE 308
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City | WESTON
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State | FL
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Zip | 33326-3256
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Country | US
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Telephone | 954-442-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 N COMMERCE PKWY STE 308
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City | WESTON
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State | FL
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Zip | 33326-3256
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Country | US
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Telephone | 954-442-1133
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARC E BOSEM
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Credential | M.D.
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Telephone | 954-437-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number | ME0067977
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License Number State | FL
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