Provider Demographics
NPI:1982872305
Name:BORON MEDICAL, INC.
Entity Type:Organization
Organization Name:BORON MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BORON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-561-2182
Mailing Address - Street 1:PO BOX 07148
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-0148
Mailing Address - Country:US
Mailing Address - Phone:239-561-2182
Mailing Address - Fax:239-561-7333
Practice Address - Street 1:13611 MCGREGOR BLVD
Practice Address - Street 2:UNIT 4
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-6042
Practice Address - Country:US
Practice Address - Phone:239-561-2182
Practice Address - Fax:239-561-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies