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NPI 1992887301

NPI 1992887301 : BRUCE L BOROS M.D., F.A.C.C. : KEY WEST, FL

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General NPI Number Information
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    NPI Number           |    1992887301
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    Entity Type          |    Individual 
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    Provider Name        |    BRUCE L BOROS M.D., F.A.C.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/19/2006
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    Last Update Date     |    04/12/2012
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Provider Practice Location Address
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    Address Line         |    3401 NORTHSIDE DR 
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    City                 |    KEY WEST
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    State                |    FL
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    Zip                  |    33040-4238
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    Country              |    US
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    Telephone            |    305-295-3331
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    Fax                  |    305-295-3387
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Provider Business Mailing Address
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    Address Line         |    3401 NORTHSIDE DR 
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    City                 |    KEY WEST
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    State                |    FL
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    Zip                  |    33040-4238
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    Country              |    US
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    Telephone            |    305-295-3331
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    Fax                  |    305-295-3387
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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        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    ME31728
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    License Number State |    FL
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