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General NPI Number Information
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NPI Number | 1568491009
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Entity Type | Individual
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Provider Name | NEDA RIAHI VANDEN BOSCH MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 05/15/2021
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Provider Practice Location Address
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Address Line | 3618 LANTANA RD STE 101
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City | LAKE WORTH
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State | FL
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Zip | 33462-2247
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Country | US
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Telephone | 561-357-2020
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Fax | 561-357-2022
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Provider Business Mailing Address
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Address Line | 3618 LANTANA RD STE 101
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City | LAKE WORTH
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State | FL
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Zip | 33462-2247
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Country | US
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Telephone | 561-357-2020
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Fax | 561-357-2022
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME85257
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License Number State | FL
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