Provider Demographics
NPI:1235276627
Name:KEMBEAT OVERSEAS INVESTMENTS PA
Entity Type:Organization
Organization Name:KEMBEAT OVERSEAS INVESTMENTS PA
Other - Org Name:BOCA FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MMC
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-391-6552
Mailing Address - Street 1:7280 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3422
Mailing Address - Country:US
Mailing Address - Phone:561-391-6552
Mailing Address - Fax:561-391-6285
Practice Address - Street 1:7280 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3422
Practice Address - Country:US
Practice Address - Phone:561-391-6552
Practice Address - Fax:561-391-6285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAV193Medicare PIN