# DR. BOUALI FREDERICK AMOLI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1306073754
- **Gender:** Man
- **Credential:** D.M.D. M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN 21029 | FL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DRP781 | FL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | ME119684 | FL | — |

## Other

- **Enumeration date:** 06/12/2009
- **Last updated:** 02/23/2015