Boston Medical Group, Inc.

NPI #1174941884 in Maitland, Florida

Provider Information

NPI Number: 1174941884
Entity Type: Organization
Organization Name: Boston Medical Group, Inc.
Primary Specialty: Urology
Enumeration Date: Mar 31, 2014
Last Updated: Mar 31, 2014

Practice Location

Address: 1001 N. LAKE DESTINY DRIVE
Address 2: SUITE 120
City: Maitland
State: Florida
ZIP Code: 32751
Phone: (407) 951-8795

Authorized Official

Name: MR. QUOC H. HA
Title: DIRECTOR
Phone: (949) 735-8451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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