Individual
MR. DOUGLAS BOAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
2200 W EAU GALLIE BLVD, MELBOURNE, FL 32935-3165
(321) 255-1500
Mailing address
2200 W EAU GALLIE BLVD, MELBOURNE, FL 32935-3165
(321) 255-1500
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
11013299
FL
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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