| Organization Name: | BOCA INTEGRATIVE HEALTH |
| NPI Number: | 1003132143 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREW JED RADER (CEO) |
| Mailing Address: | 7100 W Camino Real Ste. 207 Boca Raton |
| State: | FL US |
| Postal Code: | 334335510 |
| Phone Number: | 5613912770 |
| Fax Number: | 5613912930 |
| NPI Enumeration Date: | 04/14/2010 |
| NPI Last Update Date: | 02/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |