1477709244 NPI number — BOCA RATON REGIONAL HOSPITAL

Table of content: (NPI 1477709244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477709244 NPI number — BOCA RATON REGIONAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOCA RATON REGIONAL HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BRRH WOMEN'S INSTITUTE FOR HEALTH AND WELLNESS, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477709244
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 105046
Provider Second Line Business Mailing Address:
MAIL CODE 5598
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30348-5046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-955-4797
Provider Business Mailing Address Fax Number:
561-955-4723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
690 MEADOWS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33486-2344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-955-3772
Provider Business Practice Location Address Fax Number:
561-955-4444
Provider Enumeration Date:
08/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FEDELE
Authorized Official First Name:
JERRY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
561-955-5484

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  ME54973 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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