1679584007 NPI number — CITY OF BOCA RATON OFFICE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679584007 NPI number — CITY OF BOCA RATON OFFICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF BOCA RATON OFFICE
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:
BOCA RATON FIRE RESCUE
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:
1679584007
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 737877
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75373-7877
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-982-4000
Provider Business Mailing Address Fax Number:
561-982-4062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6500 CONGRESS AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33487-2851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-982-4000
Provider Business Practice Location Address Fax Number:
561-982-4062
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TREANOR
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
T
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
561-982-4000

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 400023400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: A0681 . This is a "PART B MEDICARE #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 400023400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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