Individual
WILSON OMAR BOADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6218 PADDOCK GLEN DR UNIT 104, TAMPA, FL 33634-5364
(787) 613-0282
Mailing address
6218 PADDOCK GLEN DR UNIT 104, TAMPA, FL 33634-5364
(787) 613-0282
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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