Organization
EAST MEDICAL OFFICE
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BOASC SR. (PRECIDENT)
(305) 510-1190
Entity
Organization
Contact information
Practice address
3778 W 12TH AVE, HIALEAH, FL 33012-4126
(305) 510-1190
(786) 534-7238
Mailing address
3778 W 12TH AVE, HIALEAH, FL 33012-4126
(305) 510-1190
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC11133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC1133
HEALTHCARE CLINIC
FL
Enumeration date
09/06/2017
Last updated
07/21/2022
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