Bolos, Youstina Ibrahim

Bolos, Youstina Ibrahim is an sole proprietor health care provider with primary practice located at 721 W Robertson St Ste 102 , Brandon FL 33511-4900. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Bolos, Youstina Ibrahim can be contacted via phone (813) 972-2000.

Contact Information

Primary practice address
721 W Robertson St Ste 102 Brandon FL 33511-4900
Phone: (813) 972-2000
Fax: (813) 558-6185
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO4044 Florida

Profile Details

NPI number 1073976429
LBN Legal business name Bolos, Youstina Ibrahim
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 2nd, 2016
Last updated Dec 2nd, 2021 - about 3 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 1073976429 NPPES
Florida MEDICAID 112180500

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