Provider Demographics
NPI:1942285770
Name:ASSOCIATED FAMILY PHYSICIANS OF BOCA RATON, P.L.
Entity Type:Organization
Organization Name:ASSOCIATED FAMILY PHYSICIANS OF BOCA RATON, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-883-3030
Mailing Address - Street 1:9910 SANDALFOOT BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-6692
Mailing Address - Country:US
Mailing Address - Phone:561-883-3030
Mailing Address - Fax:561-852-7611
Practice Address - Street 1:9910 SANDALFOOT BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-6692
Practice Address - Country:US
Practice Address - Phone:561-883-3030
Practice Address - Fax:561-852-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21642Medicare PIN