Individual
CARLAN BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
311 9TH ST N STE 100, NAPLES, FL 34102-5886
(239) 624-4670
Mailing address
8110 LOWBANK DR, NAPLES, FL 34109-0734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1578234803
FL
363A00000X
Physician Assistant
—
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9114951
FL
Other
Enumeration date
09/27/2021
Last updated
10/06/2021
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