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General NPI Number Information
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NPI Number | 1609617992
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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 | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 21550 BISCAYNE BLVD STE 133
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City | AVENTURA
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State | FL
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Zip | 33180-1258
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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 | MARC E BOSEM
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Credential | MD
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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