Organization
3XS PLLC
Active
Other names
ST MINA PRIMARY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWANDY FAWZY BOLIS M.D. (OWNER)
(352) 796-5102
Entity
Organization
Contact information
Practice address
17222 HOSPITAL BLVD, SUITE 242, BROOKSVILLE, FL 34601-8925
(352) 796-5102
(352) 796-2144
Mailing address
14391 SPRING HILL DR, SUITE 444, SPRING HILL, FL 34609-8199
(352) 796-5102
(352) 796-2144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/19/2013
Last updated
03/19/2013
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