Organization
MARIANNA PEDIATRIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOYLE LON BOSSE MD (DOCTOR OWNER)
(850) 482-2004
Entity
Organization
Contact information
Practice address
4230 HOSPITAL DR, STE 102, MARIANNA, FL 32446-1934
(850) 482-2004
(850) 482-4778
Mailing address
4230 HOSPITAL DR, STE 102, MARIANNA, FL 32446-1934
(850) 482-2004
(850) 482-4778
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME57543
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259181200
—
FL
Enumeration date
10/13/2006
Last updated
06/20/2008
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