Provider Demographics
NPI:1356359913
Name:WEST BOCA EKG READERS LLC
Entity type:Organization
Organization Name:WEST BOCA EKG READERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:FUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-483-8335
Mailing Address - Street 1:PO BOX 919303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9303
Mailing Address - Country:US
Mailing Address - Phone:954-726-1808
Mailing Address - Fax:954-726-1820
Practice Address - Street 1:21644 STATE ROAD 7
Practice Address - Street 2:- EKG READERS PANEL
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1842
Practice Address - Country:US
Practice Address - Phone:954-726-1808
Practice Address - Fax:954-726-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
34969OtherBLUE CROSS/BLUE SHIELD
34969OtherBLUE CROSS/BLUE SHIELD