MEDICARE: MARC E BOSEM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME0067977	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013951839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC E BOSEM MD

Provider Business Mailing Address
First Line	:	2300 N COMMERCE PARKWAY
Second Line	:	SUITE 201
City	:	WESTON
State	:	FL
Zip	:	33326-3255
Country	:	US
Telephone Number	:	954-217-6500
Fax Number	:	954-217-6506

Provider Business Practice Location Address
First Line	:	2300 N COMMERCE PARKWAY
Second Line	:	SUITE 201
City	:	WESTON
State	:	FL
Zip	:	33326-3255
Country	:	US
Telephone Number	:	954-217-6500
Fax Number	:	954-217-6506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/19/2021

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Directions to “ MARC E BOSEM MD” Practice Location

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