Individual
MARIA ANGELICA BOLANOS SAN ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1580 SAWGRASS CORPORATE PKWY STE 200, SUNRISE, FL 33323-2869
(954) 739-4247
Mailing address
410 E BOW DR APT A15, CHEROKEE, IA 51012-1145
(505) 205-2080
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT4440
NM
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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