Amoli, Bouali Frederick
Amoli, Bouali Frederick is an sole proprietor health care provider with primary practice located at 5149 Normandy Blvd Unit 4 , Jacksonville FL 32205-4861. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Amoli, Bouali Frederick can be contacted via phone (904) 781-1201.Contact Information
Primary practice address
5149 Normandy Blvd Unit 4
Jacksonville FL 32205-4861
Phone: (904) 781-1201
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DRP781 | Florida |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | ME119684 | Florida |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN 21029 | Florida |
Profile Details
| NPI number | 1306073754 |
|---|---|
| LBN Legal business name | Amoli, Bouali Frederick |
| Credentials | D.M.D. M.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2009 |
| Last updated | Feb 23rd, 2015 - about 9 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 | 1306073754 | NPPES |
| Florida | MEDICAID | 012224600 |
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