Provider Demographics
NPI:1992887301
Name:BOROS, BRUCE L (MD, FACC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:L
Last Name:BOROS
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4238
Mailing Address - Country:US
Mailing Address - Phone:305-295-3331
Mailing Address - Fax:305-295-3387
Practice Address - Street 1:3401 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4238
Practice Address - Country:US
Practice Address - Phone:305-295-3331
Practice Address - Fax:305-295-3387
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31728207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL170619500OtherUS DEPT. OF LABOR
FL060064507OtherRAILROAD MEDICARE
FL377189000Medicaid
FL93904OtherBC/BS FLORIDA
FL93904AMedicare ID - Type Unspecified
FL377189000Medicaid