Individual
DR. BOUALI FREDERICK AMOLI
Active
Individual
DR. BOUALI FREDERICK AMOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D. M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN 21029
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DRP781
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
ME119684
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012224600
—
FL
Enumeration date
06/12/2009
Last updated
02/23/2015
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