Healthcare Provider Details

I. General information

NPI: 1346552353
Provider Name (Legal Business Name): PAUL ALAN BOHNEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20360 GATOR LN BLDG 14
LAND O LAKES FL
34638-2802
US

IV. Provider business mailing address

20360 GATOR LN BLDG 14
LAND O LAKES FL
34638-2802
US

V. Phone/Fax

Practice location:
  • Phone: 813-346-3400
  • Fax: 813-346-3491
Mailing address:
  • Phone: 813-346-3400
  • Fax: 813-346-3491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22190
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: