Provider Demographics
NPI:1386999357
Name:NADA BOSKOVIC MD PA
Entity type:Organization
Organization Name:NADA BOSKOVIC MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:NADA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-901-0044
Mailing Address - Street 1:579 NW DICKENS CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3813
Mailing Address - Country:US
Mailing Address - Phone:561-901-0044
Mailing Address - Fax:
Practice Address - Street 1:579 NW DICKENS CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3813
Practice Address - Country:US
Practice Address - Phone:561-901-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100548207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty