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General NPI Number Information
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NPI Number | 1740460682
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Entity Type | Organization
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Legal Business Name | BOCA RATON FAMILY AND PEDIATRIC CLINIC PL
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 19801 HAMPTON DR C1-2
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City | BOCA RATON
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State | FL
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Zip | 33434-2840
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Country | US
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Telephone | 561-477-2862
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Fax | 561-477-2864
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Provider Business Mailing Address
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Address Line | 19801 HAMPTON DR C1-2
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City | BOCA RATON
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State | FL
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Zip | 33434-2840
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Country | US
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Telephone | 561-477-2862
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Fax | 561-477-2864
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LUIS A ALVAREZ
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Credential | M.D.
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Telephone | 561-477-2862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME98037
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME97494
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME98571
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License Number State | FL
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