DR. JOLLY BOSE M.D. NPI 1619116548

NPI Information

  • NPI: 1619116548
  • Provider Name: DR. JOLLY BOSE, M.D.
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 400 N STATE ROAD 19
    SUITE 48
    PALATKA, FL
    ZIP 32177
  • Phone: (386) 329-8800

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NPI Details

DR. Jolly Bose, M.D. is an adult medicine family medicine in Palatka, FL. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. DR. Jolly Bose, M.D. NPI is 1619116548. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 N STATE ROAD 19
SUITE 48
PALATKA, FL
ZIP 32177-482
Phone: (386) 329-8800

The NPI 1619116548 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/17/2009 and was last updated on 3/29/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083P0901XPreventive MedicinePublic Health & General Preventive MedicineME105828FLORIDANo
2207QA0505XFamily MedicineAdult MedicineME105828FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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