Individual
MRS. BOBBIE LYNN BULLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11807 EASTHAMPTON DR, TAMPA, FL 33626-2648
(813) 629-0976
Mailing address
11807 EASTHAMPTON DR, TAMPA, FL 33626-2648
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0002237
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA0002237
FL LICENSE
FL
Enumeration date
07/11/2006
Last updated
08/10/2016
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