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NPI 1295476422

NPI 1295476422 : DAVID BOSCH : ST PETERSBURG, FL

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General NPI Number Information
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    NPI Number           |    1295476422
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID BOSCH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/03/2022
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    Last Update Date     |    12/19/2025
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Provider Practice Location Address
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    Address Line         |    6500 38TH AVE N 
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    City                 |    ST PETERSBURG
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    State                |    FL
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    Zip                  |    33710-1629
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    Country              |    US
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    Telephone            |    727-384-7727
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    89 E 200 S UNIT 1610 
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    City                 |    SALT LAKE CITY
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    State                |    UT
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    Zip                  |    84111-2281
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    208800000X
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    Taxonomy Name        |    Urology Physician
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    License Number       |    14210097-1205
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    License Number State |    UT
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