Individual
BRIAN BOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
5816 ERHARDT DR, RIVERVIEW, FL 33578-3760
(910) 297-3569
Mailing address
5816 ERHARDT DR, RIVERVIEW, FL 33578-3760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
ARNP9185033
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
F0216882
FL
Other
Enumeration date
06/28/2016
Last updated
01/20/2020
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