Organization
FOOT, ANKLE & LEG SPECIALISTS
Active
Organization
FOOT, ANKLE & LEG SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTINE A BOLLO (PHYSICIAN)
(954) 389-5900
Entity
Organization
Contact information
Practice address
7447 N UNIVERSITY DR, TAMARAC, FL 33321-2970
(954) 389-5900
Mailing address
3607 OLD CONEJO RD, THOUSAND OAKS, CA 91320-2123
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
PO02570
FL
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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