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General NPI Number Information
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NPI Number | 1811360977
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Entity Type | Organization
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Legal Business Name | BOCA TOXICOLOGY, LLC
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 3280 N FEDERAL HWY
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City | BOCA RATON
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State | FL
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Zip | 33431-6002
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Country | US
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Telephone | 561-757-5381
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Fax | 561-757-5406
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Provider Business Mailing Address
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Address Line | 7001 N FEDERAL HWY
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City | BOCA RATON
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State | FL
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Zip | 33487-1612
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Country | US
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Telephone | 561-757-5381
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Fax | 561-757-5406
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER LICATA
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Credential |
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Telephone | 954-729-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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