Provider Demographics
NPI:1316578651
Name:BRUCE L BOROS MD PA
Entity Type:Organization
Organization Name:BRUCE L BOROS MD PA
Other - Org Name:ADVANCED URGENT CARE OF THE MIDDLE KEYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-294-0011
Mailing Address - Street 1:13365 OVERSEAS HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-3513
Mailing Address - Country:US
Mailing Address - Phone:305-294-0011
Mailing Address - Fax:
Practice Address - Street 1:13365 OVERSEAS HWY STE 102
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3513
Practice Address - Country:US
Practice Address - Phone:305-294-0011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRUCE L BOROS MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-27
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No332900000XSuppliersNon-Pharmacy Dispensing Site
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies