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General NPI Number Information
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NPI Number | 1629579990
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Entity Type | Organization
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Legal Business Name | BOCA MENTAL HEALTH INC
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 1499 W PALMETTO PARK RD STE 216
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City | BOCA RATON
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State | FL
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Zip | 33486
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Country | US
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Telephone | 561-391-4669
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Fax | 561-391-1815
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Provider Business Mailing Address
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Address Line | 1499 W PALMETTO PARK RD STE 216
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City | BOCA RATON
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State | FL
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Zip | 33486-3322
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Country | US
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Telephone | 561-391-4669
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Fax | 561-391-1815
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARIA ELA AGUILAR DONIS
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Credential |
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Telephone | 561-391-4669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME128950
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License Number State | FL
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