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Organization

JAMES J BOOKER IV MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES J BOOKER IV MD (OWNER / PROVIDER)
(863) 676-6088
Entity
Organization

Contact information

Practice address
400 AVENUE K SE, STE 2, WINTER HAVEN, FL 33880-4146
(863) 299-1107
(863) 291-3318
Mailing address
PO BOX 24506, TAMPA, FL 33623-4506
(727) 823-2188
(727) 823-9502

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
271245801
MEDICAID - WINTERHAVEN
FL
01
DD5266
RAILROAD MEDICARE
Enumeration date
08/13/2006
Last updated
02/26/2009
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