| Geriatrics Of Boca Delray Pa | |
|
16244 S Military Trl Delray Beach FL 33484-6534 | |
| (561) 865-5151 | |
| Not Available |
| Full Name | Geriatrics Of Boca Delray Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 16244 S Military Trl, Delray Beach, Florida |
| Authorized Official Name and Position | Maritza Polanco (PRESIDENT) |
| Authorized Official Contact | 5618438646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatrics Of Boca Delray Pa Po Box 6972 Delray Beach FL 33482-6972 Ph: (561) 865-5151 | Geriatrics Of Boca Delray Pa 16244 S Military Trl Delray Beach FL 33484-6534 Ph: (561) 865-5151 |
| NPI Number | 1073732475 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 02/07/2024 |
| Medicare PECOS PAC ID | 8123119666 |
|---|---|
| Medicare Enrollment ID | O20070813000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073732475 | NPI | - | NPPES |
| 279221400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME95737 (Florida) | Primary |
| Provider Name | Bruce S Levin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912095464 PECOS PAC ID: 6901876861 Enrollment ID: I20040729001182 |
| Provider Name | Ernesto Porras Polo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952332652 PECOS PAC ID: 9234132341 Enrollment ID: I20060810000223 |
| Provider Name | Eileen Fermin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265553325 PECOS PAC ID: 1557447281 Enrollment ID: I20080320000700 |
| Provider Name | Guillermo F Morel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992827091 PECOS PAC ID: 2466538194 Enrollment ID: I20080320000703 |
| Provider Name | Nevenka Metikos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790923134 PECOS PAC ID: 0042377244 Enrollment ID: I20090313000515 |
| Provider Name | Carmen Alitza Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770066672 PECOS PAC ID: 9032456272 Enrollment ID: I20190128000238 |
| Provider Name | Michelle Annette Archambault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518566090 PECOS PAC ID: 2668854605 Enrollment ID: I20220808000960 |
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