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Individual

IDRIS BOZEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
3330 NW 63RD ST, FORT LAUDERDALE, FL 33309-1611
(954) 825-8295
Mailing address
PO BOX 590342, FORT LAUDERDALE, FL 33359-0342

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5155630
FL

Other

Enumeration date
04/23/2026
Last updated
04/23/2026
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