Provider Demographics
NPI:1356770770
Name:THE ADVANCED PRP & STEM CELL CENTER OF BOCA RATON INC
Entity type:Organization
Organization Name:THE ADVANCED PRP & STEM CELL CENTER OF BOCA RATON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERKOWTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-447-7836
Mailing Address - Street 1:200 GLADES RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1424
Mailing Address - Country:US
Mailing Address - Phone:561-447-7836
Mailing Address - Fax:954-671-1222
Practice Address - Street 1:4308 ALTON RD STE 840
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4558
Practice Address - Country:US
Practice Address - Phone:561-447-7836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2772213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty