Organization
BOCA FAMILY MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRNA WAIDELE PA-C (PRESIDENT)
(561) 391-6552
Entity
Organization
Contact information
Practice address
7280 W PALMETTO PARK RD, SUITE 104, BOCA RATON, FL 33433-3422
(561) 391-6552
(561) 391-6285
Mailing address
7280 W PALMETTO PARK RD, SUITE 104, BOCA RATON, FL 33433-3422
(561) 391-6552
(561) 391-6285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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