Provider Demographics
NPI:1609821610
Name:BOE, STUART L (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:L
Last Name:BOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044403208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041882000Medicaid
FL246705OtherAVMED
FL1040152OtherCAREPLUS
FL041882000Medicaid
FL96567YMedicare PIN