Individual
LAURIE ALLISON BOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3663 S MIAMI AVE, MIAMI, FL 33133
(305) 285-2172
(724) 430-3098
Mailing address
3080 INDIANA ST, MIAMI, FL 33133
(254) 702-8210
(724) 430-3098
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS013725
PA
207P00000X
Emergency Medicine Physician
Primary
OS10258
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS013725
LICENSE NUMBER
PA
Enumeration date
07/16/2006
Last updated
08/21/2013
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