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Individual

DR. BOSE YALAMANCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PA

Contact information

Practice address
1134 WILES RD, CORAL SPRINGS, FL 33076-2114
(954) 344-4555
(954) 840-8254
Mailing address
1134 WILES RD, CORAL SPRINGS, FL 33076-2114
(954) 344-4555
(954) 840-8254

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME0040693
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
049469100
FL
01
592420003
TAX ID
FL
Enumeration date
12/09/2005
Last updated
02/20/2019
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