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Individual

ASHLEY BOTSFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
89 W COPELAND DR, ORLANDO, FL 32806
(321) 841-7550
(321) 841-8185
Mailing address
89 W COPELAND DR, ORLANDO, FL 32806
(321) 841-7550
(321) 841-8185

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9109159
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
018439700
FL
01
PA9109159
MEDICAL LICENSE
FL
Enumeration date
10/20/2015
Last updated
11/17/2016
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