Individual
MR. OMAR BOUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
6932 SW 18TH CT, POMPANO BEACH, FL 33068-4328
(954) 204-2151
Mailing address
6932 SW 18TH CT, POMPANO BEACH, FL 33068-4328
(954) 204-2151
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
22-533
WI
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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