Individual
DR. KEVIN PATRICK BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 971-6000
Mailing address
12479 TELECOM DR, TEMPLE TERRACE, FL 33637-0913
(813) 972-4199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2012-00498
NC
207P00000X
Emergency Medicine Physician
Primary
OS12732
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013031400
—
FL
05
—
5920747
—
NC
Enumeration date
06/12/2008
Last updated
11/05/2014
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