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Organization
MARY ROSE BOEHM MD PA
Active
Organization
MARY ROSE BOEHM MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ROSE BOEHM MD (PRESIDENT)
(352) 242-1430
Entity
Organization
Contact information
Practice address
200 E HIGHLAND AVE, SUITE #2, CLERMONT, FL 34711-2582
(352) 242-1430
(352) 242-1452
Mailing address
614 E HIGHWAY 50, BOX 304, CLERMONT, FL 34711-3164
(352) 242-1430
(352) 242-1452
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 88288
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7042549
AETNA
FL
01
—
81213
BLUE CROSS/BLUE SCHIELD
FL
Enumeration date
09/27/2006
Last updated
08/22/2020
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