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General NPI Number Information
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NPI Number | 1912904905
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Entity Type | Individual
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Provider Name | BRUCE W. PHILLIPS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 9960 CENTRAL PARK BLVD N SUITE 100
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City | BOCA RATON
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State | FL
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Zip | 33428-1759
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Country | US
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Telephone | 561-226-4180
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Fax | 561-226-4199
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Provider Business Mailing Address
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Address Line | 9960 CENTRAL PARK BLVD N SUITE 100
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City | BOCA RATON
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State | FL
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Zip | 33428-1759
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Country | US
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Telephone | 561-226-4180
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Fax | 561-226-4199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME 50838
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License Number State | FL
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