Individual
RICHARD J BOEHME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1361 13TH AVE S, STE-170A, JACKSONVILLE BEACH, FL 32250-3233
(904) 249-4456
(904) 249-7703
Mailing address
PO BOX 17809, JACKSONVILLE, FL 32245-7809
(904) 249-4456
(904) 249-7703
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME62533
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18695
FLORIDA BCBS
FL
01
—
212248
AVMED
FL
05
—
372291100
—
FL
01
—
P00240372
RAILROAD MEDICARE
FL
01
—
P00647889
RAILROAD MEDICARE
FL
Enumeration date
09/29/2005
Last updated
12/29/2011
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