Individual
DR. RICHARD T BOSSHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1879 NIGHTINGALE LN, A-2, TAVARES, FL 32778-4363
(352) 742-0079
(352) 742-0059
Mailing address
1879 NIGHTINGALE LN, A-2, TAVARES, FL 32778-4363
(352) 742-0079
(352) 742-0059
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME49691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035625500
—
FL
01
—
08371
BLUE SHIELD
FL
Enumeration date
07/11/2006
Last updated
06/18/2008
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