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General NPI Number Information
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NPI Number | 1477617660
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL CENTER OF BOCA RATON CORP
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 22023 STATE ROAD 7 SUITE 101
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City | BOCA RATON
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State | FL
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Zip | 33428-3401
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Country | US
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Telephone | 561-477-8081
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Fax | 561-477-9280
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Provider Business Mailing Address
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Address Line | 22023 STATE ROAD 7 SUITE 101
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City | BOCA RATON
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State | FL
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Zip | 33428-3401
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Country | US
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Telephone | 561-477-8081
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Fax | 561-477-9280
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Authorized Official
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Title or Position | PRESIDENT
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Name | TROY R WEIDLICH
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Credential | DC
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Telephone | 561-477-8081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH6095
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License Number State | FL
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