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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073976429 | NPPES |
| Florida | MEDICAID | 112180500 |
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