Provider Demographics
NPI:1710284955
Name:GARDENS MEDICAL OFFICE, INC.
Entity Type:Organization
Organization Name:GARDENS MEDICAL OFFICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BOSHERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-626-0567
Mailing Address - Street 1:7100 FAIRWAY DR
Mailing Address - Street 2:SUITE #32
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3777
Mailing Address - Country:US
Mailing Address - Phone:561-626-0567
Mailing Address - Fax:561-626-0557
Practice Address - Street 1:7100 FAIRWAY DR
Practice Address - Street 2:SUITE #32
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3777
Practice Address - Country:US
Practice Address - Phone:561-626-0567
Practice Address - Fax:561-626-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty