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Individual

JOHN W BOOHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1100 NE 45TH ST, SUITE 102, OAKLAND PARK, FL 33334-3814
(954) 629-0250
(866) 240-3482
Mailing address
1100 NE 45TH ST, SUITE 102, OAKLAND PARK, FL 33334-3814
(954) 629-0250
(866) 240-3482

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102244
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
291430100
FL
01
Y04T2
BC BS FL
FL
Enumeration date
04/07/2006
Last updated
06/02/2015
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