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General NPI Number Information
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NPI Number | 1740441690
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Entity Type | Organization
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Legal Business Name | HIGHLAND MEDICAL GROUP, INC
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 500 NE SPANISH RIVER BLVD SUITE 31
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City | BOCA RATON
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State | FL
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Zip | 33431-4515
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Country | US
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Telephone | 561-789-9558
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NE SPANISH RIVER BLVD SUITE 31
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City | BOCA RATON
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State | FL
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Zip | 33431-4515
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Country | US
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Telephone | 561-789-9558
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RODNEY DUNETZ
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Credential |
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Telephone | 561-789-9558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | AP 2564
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License Number State | FL
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