Provider Demographics
NPI:1154745875
Name:BOCA CARDIAC SURGERY LLC
Entity type:Organization
Organization Name:BOCA CARDIAC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARTLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-955-6300
Mailing Address - Street 1:801 MEADOWS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2346
Mailing Address - Country:US
Mailing Address - Phone:561-955-6300
Mailing Address - Fax:561-955-6310
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-955-6300
Practice Address - Fax:561-955-6310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty