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General NPI Number Information
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NPI Number | 1750311627
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Entity Type | Individual
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Provider Name | TERRY L. BOECKEL OD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 N FEDERAL HWY STE B
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1016
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Country | US
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Telephone | 954-783-9322
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Fax | 954-783-6676
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Provider Business Mailing Address
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Address Line | 1017 MANGO ISLE
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City | FT LAUDERDALE
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State | FL
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Zip | 33315-1327
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Country | US
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Telephone | 305-785-2986
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Fax | 954-783-6676
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 3432
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License Number State | FL
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