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General NPI Number Information
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NPI Number | 1033447750
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Entity Type | Individual
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Provider Name | JOANNA S. BOOTH LMT
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Gender | Female
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 2301 DELGADO DR
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City | TALLAHASSEE
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State | FL
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Zip | 32304-1301
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Country | US
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Telephone | 850-574-7022
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Fax | 850-574-7023
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Provider Business Mailing Address
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Address Line | PO BOX 20066
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City | TALLAHASSEE
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State | FL
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Zip | 32316-0066
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Country | US
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Telephone | 850-574-7022
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Fax | 850-574-7023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Y00000X
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Taxonomy Name | Health Information Specialist/Technologist
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License Number | MA 29864
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License Number State | FL
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