IndividualActive
James Provo, MD
NPI 1346278264 · Sports Medicine (Family Medicine) Physician · Boca Raton, FL
Provider details
- NPI number
- 1346278264
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- ME67309 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
4705 N Federal Hwy
Boca Raton, FL 33431-5135
Phone: (561) 220-2622
Fax: (561) 257-1922
Approximate (ZIP-level) locationGet directions
Mailing address
180 John F Kennedy Dr Ste 100
Atlantis, FL 33462-6641
Registry dates
- Enumerated
- 2006-06-29
- Last updated
- 2024-06-06
- Certified
- 2024-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.