Provider Demographics
NPI:1962841163
Name:TOMAN ORTHOPEDICS AND SPORTS MEDICINE, PA
Entity Type:Organization
Organization Name:TOMAN ORTHOPEDICS AND SPORTS MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:V
Authorized Official - Last Name:TOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-221-6895
Mailing Address - Street 1:21346 SAINT ANDREWS BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2432
Mailing Address - Country:US
Mailing Address - Phone:561-221-6895
Mailing Address - Fax:561-221-6896
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:#100B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-221-6895
Practice Address - Fax:561-221-6896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty