Provider Demographics
NPI:1730723586
Name:BOCA SURGERY SERVICES INC
Entity type:Organization
Organization Name:BOCA SURGERY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:RONALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-853-1470
Mailing Address - Street 1:408 NE 6TH ST UNIT 525
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-6412
Mailing Address - Country:US
Mailing Address - Phone:786-853-1470
Mailing Address - Fax:
Practice Address - Street 1:408 NE 6TH ST UNIT 525
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-6412
Practice Address - Country:US
Practice Address - Phone:786-853-1470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY055NOtherFLORIDA BLUE