Individual
CASSANDRA BOLTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 SW 8TH ST, MIAMI, FL 33199-2516
(305) 348-2000
Mailing address
12 AUSTIN ROAD, JOHANNESBURG, GAUTENG 01685
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0000000000
—
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
00000000
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6314201
FIU ID
FL
Enumeration date
07/13/2021
Last updated
07/13/2021
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