| Boynton Beach Medical | |
|
709 S Federal Hwy Ste 3 Boynton Beach FL 33435-5610 | |
| (561) 735-6553 | |
| (561) 735-7739 |
| Full Name | Boynton Beach Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 709 S Federal Hwy Ste 3, Boynton Beach, Florida |
| Authorized Official Name and Position | Deanna Moultrie Warren (CEO) |
| Authorized Official Contact | 5617356553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boynton Beach Medical 639 E Ocean Ave Ste 409 Boynton Beach FL 33435-5017 Ph: (561) 806-6835 | Boynton Beach Medical 709 S Federal Hwy Ste 3 Boynton Beach FL 33435-5610 Ph: (561) 735-6553 |
| NPI Number | 1447578125 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 11/04/2024 |
| Medicare PECOS PAC ID | 7012033384 |
|---|---|
| Medicare Enrollment ID | O20110112000690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447578125 | NPI | - | NPPES |
| 002267000 | Medicaid | FL | |
| EC290A | Other | FL | MEDICARE |
| 006608600 | Medicaid | FL | |
| 101108 | Other | FL | MEDICARE |
| Provider Name | Donna Ducille |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629020631 PECOS PAC ID: 7113990573 Enrollment ID: I20040816000164 |
| Provider Name | Allison Holley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104050848 PECOS PAC ID: 5991977951 Enrollment ID: I20111017000602 |
| Provider Name | Sarah Wiggill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427377886 PECOS PAC ID: 6204095961 Enrollment ID: I20120315000553 |
| Provider Name | Dione A Occenad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043500374 PECOS PAC ID: 7012227788 Enrollment ID: I20151109001369 |
| Provider Name | Sonia Cuellar Mejia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730340704 PECOS PAC ID: 7012195795 Enrollment ID: I20151228001363 |
| Provider Name | Marie Eilis Tessa Vadil Onia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881104362 PECOS PAC ID: 4981933546 Enrollment ID: I20190906000692 |
| Provider Name | Ravi Nagraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609163815 PECOS PAC ID: 2062634199 Enrollment ID: I20201210002315 |
| Provider Name | Wayne Lee Berry |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1053324376 PECOS PAC ID: 2668777699 Enrollment ID: I20210223001567 |
| Provider Name | Kerline Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710417027 PECOS PAC ID: 7618235722 Enrollment ID: I20210224000058 |
| Provider Name | Sava Estanboliah |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1235512526 PECOS PAC ID: 8527314863 Enrollment ID: I20211027003382 |
| Provider Name | Rancha Exantus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245839612 PECOS PAC ID: 7618364274 Enrollment ID: I20220428002086 |
| Provider Name | Mikaela B Benlulu |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1295275642 PECOS PAC ID: 3678952546 Enrollment ID: I20220623001190 |
| Provider Name | Sharon Anitha Jacob |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1073249983 PECOS PAC ID: 0547620064 Enrollment ID: I20230717000099 |
| Provider Name | Lisette L Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669018750 PECOS PAC ID: 3173986726 Enrollment ID: I20230829003744 |
| Provider Name | Ledesha M Maduro |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1174982458 PECOS PAC ID: 5395018022 Enrollment ID: I20231116003611 |
| Provider Name | Crystal Charmaine Ramdeo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225611924 PECOS PAC ID: 8123467743 Enrollment ID: I20240416001609 |
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