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General NPI Number Information
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NPI Number | 1477662310
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Entity Type | Organization
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Legal Business Name | BOCA HEART GROUP P A
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 601 N CONGRESS AVE SUITE 402
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4621
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Country | US
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Telephone | 561-274-8933
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Fax | 561-274-8869
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Provider Business Mailing Address
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Address Line | 601 N CONGRESS AVE SUITE 402
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4621
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Country | US
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Telephone | 561-274-8933
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Fax | 561-274-8869
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. CARLOS A COWLEY
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Credential | MD
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Telephone | 561-274-8933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME52904
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License Number State | FL
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