Provider Demographics
NPI:1760614754
Name:BOYNTON MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:BOYNTON MANAGEMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:B
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-736-2001
Mailing Address - Street 1:3795 W BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4502
Mailing Address - Country:US
Mailing Address - Phone:561-736-2001
Mailing Address - Fax:561-740-0771
Practice Address - Street 1:3795 W BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4502
Practice Address - Country:US
Practice Address - Phone:561-736-2001
Practice Address - Fax:561-740-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty