Sea Grape Medical Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

ME54025 Issued in FL

Legal business name

SEA GRAPE MEDICAL INC

Practice address

101 SE Mizner Blvd
Boca Raton, FL 33432-5007

Phone

(561) 391-8343

NPI assigned

Oct 11, 2012

Last updated

Oct 11, 2012By 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

Arlene Spertus, MD

Title

Owner

Phone

(954) 551-4072

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1598017725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SE MIZNER BLVD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325007",
            "telephone_number": "561-391-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SE MIZNER BLVD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325007",
            "telephone_number": "561-391-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA GRAPE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "SPERTUS",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-551-4072",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME54025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.