Organization
BOCA MEDICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY TESIC (CEO)
(561) 338-6897
Entity
Organization
Contact information
Practice address
1000 E HILLSBORO BLVD, SUITE 104, DEERFIELD BEACH, FL 33441-3628
(954) 363-7494
(954) 363-7497
Mailing address
1000 E HILLSBORO BLVD, SUITE 104, DEERFIELD BEACH, FL 33441-3628
(954) 363-7494
(954) 363-7497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH0006645
FL
174400000X
Specialist
PT12916
FL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
OS6072
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC5812
CLINIC
FL
Enumeration date
09/16/2005
Last updated
05/22/2014
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