Individual
DR. WANDA M BOOTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2060 5TH AVE N, ST PETERSBURG, FL 33713-8012
(727) 895-3376
(727) 362-3376
Mailing address
2060 5TH AVE N, ST PETERSBURG, FL 33713-8012
(727) 895-3376
(727) 362-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
53607
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070012797
RR MEDICARE PROV NUMBER
FL
Enumeration date
09/14/2006
Last updated
09/18/2007
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