Bocacare 9TH Avenue Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME42340 Issued in FL

Legal business name

BOCACARE 9TH AVENUE INC

Practice address

1599 NW 9TH Ave
Suite 203
Boca Raton, FL 33486-1310

Phone

(561) 392-6666

Fax

(561) 392-1583

NPI assigned

Aug 18, 2009

Last updated

Aug 18, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerry J Fedele

Title

Ceo

Phone

(561) 392-6666

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1235361635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 NW 9TH AVE",
            "address_2": "SUITE 203",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861310",
            "telephone_number": "561-392-6666",
            "fax_number": "561-392-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 NW 9TH AVE",
            "address_2": "SUITE 203",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861310",
            "telephone_number": "561-392-6666",
            "fax_number": "561-392-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCACARE 9TH AVENUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "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": "561-392-6666",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME42340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "73258",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Boca/Delray Renal Associates, Inc
• Bocacare East Inc
• Bocacare Inc (Baptist Health Medical Group North)
• Bocacare Inc (Baptist Health Medical Group North)
• Bocacare Inc
• Bocacare Inc

• Internal Medicine Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.