| Entity Name: | BOCA HEART GROUP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 May 2000 (25 years ago) |
| Document Number: | P00000049327 |
| FEI/EIN Number | 651008498 |
| Mail Address: | 900 Biscayne Blvd, Miami, FL, 33132, US |
| Address: | 900 Biscayne Blvd., Miami, FL, 33445, US |
| ZIP code: | 33445 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477662310 | 2006-08-30 | 2011-10-17 | 601 N CONGRESS AVE, SUITE 402, DELRAY BEACH, FL, 334454621, US | 601 N CONGRESS AVE, SUITE 402, DELRAY BEACH, FL, 334454621, US | |||||||||||||||||||||||||
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| Phone | +1 561-274-8933 |
| Fax | 5612748869 |
Authorized person
| Name | DR. CARLOS A COWLEY |
| Role | MEDICAL DOCTOR |
| Phone | 5612748933 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME52904 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 254010000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COWLEY CARLOS A | Agent | 900 Biscayne Blvd., Miami, FL, 33445 |
| Name | Role | Address |
|---|---|---|
| Cowley Carlos A | President | 900 Biscayne Blvd., Miami, FL, 33445 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2010-10-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
