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General NPI Number Information
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NPI Number | 1861765828
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Entity Type | Organization
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Legal Business Name | BOCA DEL MAR PEDIATRIC AND ADOLESCENT CENTER
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Dates
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Enumeration Date | 02/21/2012
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 21301 POWERLINE RD STE 106
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City | BOCA RATON
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State | FL
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Zip | 33433-2389
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Country | US
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Telephone | 866-550-2212
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Fax | 561-516-7362
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Provider Business Mailing Address
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Address Line | 21301 POWERLINE RD STE 106
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City | BOCA RATON
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State | FL
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Zip | 33433-2389
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Country | US
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Telephone | 866-550-2212
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Fax | 561-516-7362
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Authorized Official
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Title or Position | MANAGER
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Name | MEGAN EMSALEM
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Credential |
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Telephone | 866-550-2212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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