Individual
HOOSHANG MICHAEL BOLOOKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8960 COLONIAL CENTER DR, SUITE 302, FORT MYERS, FL 33905
(239) 343-9700
(239) 343-9699
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9700
(239) 343-9699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35088092
OH
207RC0000X
Cardiovascular Disease Physician
49677
MN
207RC0000X
Cardiovascular Disease Physician
Primary
ME107586
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002523700
—
FL
Enumeration date
08/16/2006
Last updated
03/24/2021
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