Individual
MR. BRUCE BOSTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIANS ASSISTANT
Contact information
Practice address
6550 N FEDERAL HWY, SUITE 512, FT LAUDERDALE, FL 33308-1404
(954) 267-8777
(954) 772-7801
Mailing address
PO BOX 70533, FT LAUDERDALE, FL 33307-0533
(954) 267-8777
(954) 772-7801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3374
FL
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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