Individual
WILLIAM BEDFORD BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
880 SW 145TH AVE STE 202, PEMBROKE PINES, FL 33027-6171
(866) 849-0692
(888) 973-8821
Mailing address
PO BOX 211699, EAGAN, MN 55121-3699
(866) 849-0692
(888) 973-8821
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME150805
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
BRIGHAM AND WOMEN'S HOSPITAL
MA
Enumeration date
05/12/2018
Last updated
05/28/2024
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