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General NPI Number Information
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NPI Number | 1063735926
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Entity Type | Individual
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Provider Name | IVETTE ELIZABETH BOLER ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 1840 MEASE DR SUITE 309
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-6602
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Country | US
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Telephone | 727-216-1141
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Fax | 727-796-1590
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Provider Business Mailing Address
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Address Line | 1201 5TH AVE N SUITE 505
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City | ST PETERSBURG
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State | FL
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Zip | 33705-1400
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Country | US
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Telephone | 727-821-0017
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Fax | 727-502-8861
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | ARNP 1249762
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License Number State | FL
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