Boccardo, Justin
Boccardo, Justin is an individual health care provider with primary practice located at 2401 Frist Blvd Ste 4 , Fort Pierce FL 34950-4800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Boccardo, Justin can be contacted via phone (772) 595-5302.Contact Information
Primary practice address
2401 Frist Blvd Ste 4
Fort Pierce FL 34950-4800
Phone: (772) 595-5302
Fax: (772) 595-5304
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | MD432316 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | ME125876 | Florida |
Profile Details
| NPI number | 1598887275 |
|---|---|
| LBN Legal business name | Boccardo, Justin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2007 |
| Last updated | Feb 10th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598887275 | NPPES |
| Pennsylvania | MEDICAID | 102479013 0001 |
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