Boote, Wanda M

Boote, Wanda M is an sole proprietor health care provider with primary practice located at 2060 5Th Ave N , St Petersburg FL 33713-8012. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Boote, Wanda M can be contacted via phone (727) 895-3376.

Contact Information

Primary practice address
2060 5Th Ave N St Petersburg FL 33713-8012
Phone: (727) 895-3376
Fax: (727) 362-3376
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 53607 Florida

Profile Details

NPI number 1063517050
LBN Legal business name Boote, Wanda M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2006
Last updated Sep 18th, 2007 - about 18 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 1063517050 NPPES
Florida Other 070012797 RR MEDICARE PROV NUMBER

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