# INTERMED OF BOCA RATON, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407212327
- **Authorized official:** CHANTAL BRAY (CEO)
- **Authorized official phone:** (954) 254-7968

## Contact information

- **Practice address:** 950 GLADES RD STE 4D, BOCA RATON, FL 33431-6401
- **Practice address phone:** (561) 391-8086
- **Practice address fax:** (954) 354-8151
- **Mailing address:** 4855 W HILLSBORO BLVD, SUITE B2, COCONUT CREEK, FL 33073-4356
- **Mailing address phone:** (954) 418-1683
- **Mailing address fax:** (954) 354-8151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | Yes |
| 207K00000X | Allergy & Immunology Physician | — | — | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 01/07/2016
- **Last updated:** 07/12/2021