Organization
EDGAR B BOLTON DO PA
Active
Organization
EDGAR B BOLTON DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR B BOLTON JR. DO (PRESIDENT)
(954) 445-1754
Entity
Organization
Contact information
Practice address
1512 SE 10TH ST, FORT LAUDERDALE, FL 33316-1420
(954) 445-1754
(954) 766-8199
Mailing address
1512 SE 10TH ST, FORT LAUDERDALE, FL 33316-1420
(954) 445-1754
(954) 766-8199
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
OS 2458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037708200
—
FL
Enumeration date
05/30/2013
Last updated
11/06/2013
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