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EDGAR B BOLTON DO PA NPI 1790122778


NPI Information

NPI: 1790122778
Provider Name: EDGAR B BOLTON DO PA
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
1512 SE 10TH ST
FORT LAUDERDALE, FL
ZIP 33316
Phone: (954) 445-1754
Get Directions

EDGAR B BOLTON DO PA is a pulmonary disease internal medicine in Fort Lauderdale, FL. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. EDGAR B BOLTON DO PA NPI is 1790122778. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1512 SE 10TH ST
FORT LAUDERDALE, FL
ZIP 33316-420
Phone: (954) 445-1754
Fax: (954) 766-8199

The provider's authorized official is Edgar B Bolton .
The authorized official title is President and has the following contact phone number (954) 445-1754.

The enumeration date for this NPI number is 5/30/2013 and was last updated on 11/6/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RP1001XInternal MedicinePulmonary DiseaseOS 2458FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E12175MEDICARE UPINFLORIDA
2037708200MEDICAIDFLORIDA

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: 11/14/2023

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