Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN11014535 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRRN11014535 | FL |
NPI | 1356015911 |
---|---|
Provider Name | Eric Ian Boruck |
First Address | Miami, FL 33186-2767 |
Second Address | Miami, FL 33156-7397 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2021 |
Last Update Date | 05/08/2021 |