Organization
ALICE BOLTON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICE BOLTON ARNP,MS,CS,BC (OWNER)
(941) 629-0282
Entity
Organization
Contact information
Practice address
2750 BAHIA VISTA,, STE 108, SARASOTA, FL 34239-2636
(941) 954-1101
Mailing address
2577 EDNOR ST, PORT CHARLOTTE, FL 33952-4335
(941) 629-0282
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
ARNP478692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y3362
BC/BS
FL
Enumeration date
01/03/2011
Last updated
01/03/2011
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