Bolos, Peter R.

Bolos, Peter R. is an individual health care provider with primary practice located at 1208 Merry Water Dr , Lutz FL 33548-4807. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bolos, Peter R. can be contacted via phone (813) 477-9979.

Contact Information

Primary practice address
1208 Merry Water Dr Lutz FL 33548-4807
Phone: (813) 477-9979
Fax: (888) 688-1659
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD433914 Pennsylvania
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X D80591 Maryland
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME104023 Florida

Profile Details

NPI number 1457523987
LBN Legal business name Bolos, Peter R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2008
Last updated Sep 16th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457523987 NPPES
Florida MEDICAID 009111600
Florida Other 14N46

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