Provider Demographics
NPI:1225445174
Name:BOCA BABES OBGYN, LLC
Entity Type:Organization
Organization Name:BOCA BABES OBGYN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTZLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-702-1329
Mailing Address - Street 1:1880 N. CONGRESS AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1880 N. CONGRESS AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426
Practice Address - Country:US
Practice Address - Phone:561-702-1329
Practice Address - Fax:888-734-6559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009357600Medicaid
FL009357600Medicaid