Provider Demographics
NPI:1841596095
Name:BOCA MEDICAL CARE
Entity Type:Organization
Organization Name:BOCA MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MCC
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-470-1110
Mailing Address - Street 1:9834 GLADES RD
Mailing Address - Street 2:SUTIE C-5
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3995
Mailing Address - Country:US
Mailing Address - Phone:561-470-1110
Mailing Address - Fax:561-470-1184
Practice Address - Street 1:9834 GLADES RD
Practice Address - Street 2:SUTIE C-5
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3995
Practice Address - Country:US
Practice Address - Phone:561-470-1110
Practice Address - Fax:561-470-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty