Provider Demographics
NPI:1902826779
Name:BOCA RATON REGIONAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:BOCA RATON REGIONAL HOSPITAL, INC.
Other - Org Name:BOCA RATON COMMUNITY HOSPITAL, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINCOLN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-955-3032
Mailing Address - Street 1:800 MEADOWS ROAD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-9952
Mailing Address - Country:US
Mailing Address - Phone:561-955-4200
Mailing Address - Fax:561-955-5151
Practice Address - Street 1:800 MEADOWS ROAD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-9952
Practice Address - Country:US
Practice Address - Phone:561-955-4200
Practice Address - Fax:561-955-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3983282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010141900Medicaid
FL010141900Medicaid
100168Medicare Oscar/Certification