Organization
BOCA RATON PHYSICIANS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KEISHA MCDONNOUGH (OFFICE MANAGER)
(561) 994-5454
Entity
Organization
Contact information
Practice address
1905 CLINT MOORE RD STE 201, BOCA RATON, FL 33496-2660
(561) 994-5454
(561) 994-8873
Mailing address
1905 CLINT MOORE RD STE 201, BOCA RATON, FL 33496-2660
(561) 994-5454
(561) 994-8873
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97108
BLUE CROSS BLUE SHIELD
FL
01
—
DG0687
RAILROAD MEDICARE
—
Enumeration date
08/15/2006
Last updated
10/30/2023
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