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General NPI Number Information
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NPI Number | 1750742904
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Entity Type | Organization
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Legal Business Name | BOCA MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 5458 TOWN CENTER RD 25
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City | BOCA RATON
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State | FL
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Zip | 33486-1089
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Country | US
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Telephone | 561-430-3492
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Fax |
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Provider Business Mailing Address
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Address Line | 5458 TOWN CENTER RD 25
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City | BOCA RATON
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State | FL
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Zip | 33486-1089
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Country | US
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Telephone | 561-430-3492
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID MARQUIS
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Credential | D.O.
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Telephone | 561-430-3492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | OS7851
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License Number State | FL
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