Individual
JODI L BOSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
83 W MILLER ST, ORLANDO, FL 32806-2031
(321) 843-2584
(352) 265-6922
Mailing address
1613 N. HARRISON PARKWAY, SUITE 200, MAILSTOP SH-9A, SUNRISE, FL 33323-2896
(954) 838-2371
(954) 851-1746
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME110241
FL
207L00000X
Anesthesiology Physician
MT188050
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003763000
—
FL
Enumeration date
04/23/2007
Last updated
08/08/2016
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