Provider Demographics
NPI:1205821618
Name:BOCA DELRAY CARDIOLOGY, P.A.
Entity type:Organization
Organization Name:BOCA DELRAY CARDIOLOGY, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-499-9990
Mailing Address - Street 1:5210 LINTON BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6537
Mailing Address - Country:US
Mailing Address - Phone:561-499-9990
Mailing Address - Fax:561-499-9465
Practice Address - Street 1:5210 LINTON BLVD STE 303
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6537
Practice Address - Country:US
Practice Address - Phone:561-499-9990
Practice Address - Fax:561-499-9465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCF8738OtherMEDICARE RAILROAD
FL10747ZOtherDR BRUCE RICHARD MARTIN PTAN
FL1598759979OtherDR BRUCE RICHARD MARTIN NPI
FL38710Medicare ID - Type Unspecified
FL1598759979OtherDR BRUCE RICHARD MARTIN NPI
FL38710Medicare ID - Type Unspecified