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NPI Code Detail

MEDICARE: DR. BRIAN ROBERT BOGGS MD

MEDICARE: DR. BRIAN ROBERT BOGGS 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
1207P00000XEmergency Medicine PhysicianME94032FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128695OTHERFLBCBS

General Provider Information

NPI Number : 1447234463
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN ROBERT BOGGS MD
Provider Business Mailing Address
First Line : 701 W COCOA BEACH CSWY
Second Line : CAPE CANAVERAL HOSPITAL EMERGENCY ROOM
City : COCOA BEACH
State : FL
Zip : 32931-3585
Country : US
Telephone Number : 321-799-7150
Fax Number : 321-868-7249
Provider Business Practice Location Address
First Line : 701 W COCOA BEACH CSWY
Second Line : CAPE CANAVERAL HOSPITAL EMERGENCY ROOM
City : COCOA BEACH
State : FL
Zip : 32931-3585
Country : US
Telephone Number : 321-799-7150
Fax Number : 321-868-7249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 07/08/2007

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