Provider Demographics
NPI:1285690131
Name:BOCA FERTILITY, INC
Entity Type:Organization
Organization Name:BOCA FERTILITY, INC
Other - Org Name:BOCA FERTILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PERESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-368-5500
Mailing Address - Street 1:875 MEADOWS ROAD
Mailing Address - Street 2:SUITE 334
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486
Mailing Address - Country:US
Mailing Address - Phone:561-368-5500
Mailing Address - Fax:561-368-4793
Practice Address - Street 1:875 MEADOWS ROAD
Practice Address - Street 2:SUITE 334
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-368-5500
Practice Address - Fax:561-368-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0039615207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D39107Medicare UPIN