Organization
SOUTH FLORIDA MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN S DIETZ (CEO)
(561) 443-3522
Entity
Organization
Contact information
Practice address
6462 E ROGERS CIR, BOCA RATON, FL 33487-2653
(561) 443-3522
(561) 443-3312
Mailing address
6462 E ROGERS CIR, BOCA RATON, FL 33487-2653
(561) 443-3522
(561) 443-3312
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
2003-04453
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
952006600
—
FL
01
—
R8660
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/01/2005
Last updated
11/04/2010
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