Provider Demographics
NPI:1912554437
Name:NADA BOSKOVIC MD PA
Entity Type:Organization
Organization Name:NADA BOSKOVIC MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:NADA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-901-0044
Mailing Address - Street 1:1 W SAMPLE ROAD, SUITE 305
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:561-901-0044
Mailing Address - Fax:
Practice Address - Street 1:1 W SAMPLE ROAD, SUITE 305
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:561-901-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NADA BOSKOVIC MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty