| Boca Raton Gastroenterology Center P A | |
|
1000 Nw 9th Ct Suite 204 Boca Raton FL 33486-2268 | |
| (561) 395-5204 | |
| (561) 395-6177 |
| Full Name | Boca Raton Gastroenterology Center P A |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Nw 9th Ct, Boca Raton, Florida |
| Authorized Official Name and Position | Robert Leon Mellman (PRESIDENT) |
| Authorized Official Contact | 5613955204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boca Raton Gastroenterology Center P A 1000 Nw 9th Ct Suite 204 Boca Raton FL 33486-2268 Ph: (561) 395-5204 | Boca Raton Gastroenterology Center P A 1000 Nw 9th Ct Suite 204 Boca Raton FL 33486-2268 Ph: (561) 395-5204 |
| NPI Number | 1497878987 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 09/02/2010 |
| Medicare PECOS PAC ID | 5395732747 |
|---|---|
| Medicare Enrollment ID | O20040427001745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497878987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Robert Leon Mellman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457381907 PECOS PAC ID: 1759378102 Enrollment ID: I20100903000951 |
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