Organization
SOUTH COUNTY ENDOCRINOLOGY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRTHA KELIJMAN MD (PRESIDENT)
(561) 367-8202
Entity
Organization
Contact information
Practice address
670 GLADES RD, SUITE 310, BOCA RATON, FL 33431-6461
(561) 367-8202
(561) 367-8257
Mailing address
670 GLADES RD, SUITE 310, BOCA RATON, FL 33431-6461
(561) 367-8202
(561) 367-8257
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME 67985
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
252927
AVMED
FL
01
—
44842
BLUE CROSS BLUE SHIELD OF FLA
FL
01
—
FP0935
HEALTHNET
FL
01
—
P00064212
RAILROAD MEDICARE
FL
Enumeration date
04/20/2006
Last updated
05/20/2008
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