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General NPI Number Information
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NPI Number | 1710284955
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Entity Type | Organization
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Legal Business Name | GARDENS MEDICAL OFFICE, INC.
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 7100 FAIRWAY DR SUITE #32
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-3777
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Country | US
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Telephone | 561-626-0567
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Fax | 561-626-0557
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Provider Business Mailing Address
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Address Line | 7100 FAIRWAY DR SUITE #32
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-3777
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Country | US
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Telephone | 561-626-0567
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Fax | 561-626-0557
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Authorized Official
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Title or Position | OWNER
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Name | DR. BEAU RICHARD BOSHERS
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Credential | M.D.
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Telephone | 561-626-0567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME98041
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License Number State | FL
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