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Organization
W.P. BOORAS, M.D., P.A.
Active
Organization
W.P. BOORAS, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES H BOORAS M.D. (PRESIDENT)
(904) 721-7844
Entity
Organization
Contact information
Practice address
1922 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-8933
(904) 721-7844
(904) 727-3597
Mailing address
1922 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-8933
(904) 721-7844
(904) 727-3597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0040719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080025632
PALMETTO GBA - RAILROAD
GA
01
—
15776
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/15/2006
Last updated
07/02/2008
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