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General NPI Number Information
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NPI Number | 1770380792
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Entity Type | Organization
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Legal Business Name | BOFILL SERVICES GROUP, LLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 6628 SW 113TH AVE # 6628
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City | MIAMI
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State | FL
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Zip | 33173-1972
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Country | US
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Telephone | 786-287-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 6628 SW 113TH AVE # 6628
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City | MIAMI
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State | FL
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Zip | 33173-1972
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Country | US
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Telephone | 786-357-7968
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MADELEYNE BOFILL
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Credential | RN
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Telephone | 786-357-7968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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