Individual
SHEREE BOLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16452 CHAMPLAIN ST, CLERMONT, FL 34714-6602
(321) 443-7844
Mailing address
16452 CHAMPLAIN ST, CLERMONT, FL 34714-6602
(321) 443-7844
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
EMT525827
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7863673267
—
FL
Enumeration date
04/14/2022
Last updated
04/14/2022
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