Individual
ALICIA KRISTINA BOATENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6613 SW 18TH CT, NORTH LAUDERDALE, FL 33068-5219
(305) 401-7001
Mailing address
6613 SW 18TH CT, NORTH LAUDERDALE, FL 33068-5219
(305) 401-7001
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
W259870
FL
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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