Individual
CARLAN BOSTICK
Active
Individual
CARLAN BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1578234803
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9114951
FL
Other
Enumeration date
09/27/2021
Last updated
10/06/2021
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