Provider Demographics
NPI:1598782427
Name:STUART L BOE MD PA
Entity Type:Organization
Organization Name:STUART L BOE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-942-7083
Mailing Address - Street 1:5333 N DIXIE HWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3414
Mailing Address - Country:US
Mailing Address - Phone:954-942-7083
Mailing Address - Fax:954-491-9899
Practice Address - Street 1:5333 N DIXIE HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3414
Practice Address - Country:US
Practice Address - Phone:954-942-7083
Practice Address - Fax:954-491-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044403208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCF906AMedicare PIN