Individual
JOSEPH BOATENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(956) 362-3548
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1096
(305) 243-2067
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
39
FL
390200000X
Student in an Organized Health Care Education/Training Program
39
TX
Other
Enumeration date
05/02/2020
Last updated
07/20/2021
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