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General NPI Number Information
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NPI Number | 1902968860
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Entity Type | Organization
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Legal Business Name | BOCA PODIATRY GROUP, P.A.
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 1353 W PALMETTO PARK RD
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City | BOCA RATON
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State | FL
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Zip | 33486-3303
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Country | US
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Telephone | 561-750-3060
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Fax | 561-750-3011
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Provider Business Mailing Address
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Address Line | 1353 W PALMETTO PARK RD
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City | BOCA RATON
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State | FL
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Zip | 33486-3303
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Country | US
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Telephone | 561-750-3060
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Fax | 561-750-3011
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL ALAN SOMMER
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Credential | DPM
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Telephone | 561-750-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO2245
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License Number State | FL
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