# BOOST MEDICAL LLC

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

## Provider details

- **NPI number:** 1750089009
- **Authorized official:** AMANDA RUTLEDGE (CEO)
- **Authorized official phone:** (936) 648-5161

## Contact information

- **Practice address:** 13798 NW 4TH ST STE 311, SUNRISE, FL 33325-6227
- **Practice address phone:** (754) 778-8235
- **Mailing address:** 13798 NW 4TH ST STE 311, SUNRISE, FL 33325-6227
- **Mailing address phone:** (754) 778-8235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician | — | NULL | Yes |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician | — | — | Yes |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |

## Other

- **Enumeration date:** 02/16/2023
- **Last updated:** 02/16/2023