Organization
DR. BORIS KAWLICHE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BORIS L. KAWLICHE M.D. (OWNER)
(813) 681-5880
Entity
Organization
Contact information
Practice address
401 N PARSONS AVE, SUITE 107A, BRANDON, FL 33510-4538
(813) 681-5880
(813) 681-5958
Mailing address
401 N PARSONS AVE, SUITE 107A, BRANDON, FL 33510-4538
(813) 681-5880
(813) 681-5958
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME66500
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378031700
—
FL
Enumeration date
04/15/2014
Last updated
04/15/2014
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