Individual
MR. JUAN MANUEL BOLIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
50 W STUTERVANT STREET, ORLANDO, FL 32806-4000
(407) 649-6907
(407) 481-2035
Mailing address
3200 SW 60TH CT, MIAMI, FL 33155-4000
(305) 662-8301
(305) 662-8304
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
ME75602
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273499100
—
FL
Enumeration date
02/14/2006
Last updated
07/08/2007
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