Provider Demographics
NPI:1619996675
Name:BOROS, BECKY ARLENE (DC)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:ARLENE
Last Name:BOROS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26381 S TAMIAMI TRL STE 128
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7803
Mailing Address - Country:US
Mailing Address - Phone:708-580-2063
Mailing Address - Fax:
Practice Address - Street 1:26381 S TAMIAMI TRL STE 128
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7803
Practice Address - Country:US
Practice Address - Phone:708-580-2063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038005553111N00000X
FLAP2972171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL94565Medicare PIN
ILP00147523Medicare PIN
ILT38728Medicare UPIN