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General NPI Number Information
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NPI Number | 1801217971
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Entity Type | Organization
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Legal Business Name | EVA KAREN BOSWELL O.D.P.A
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 7450 CYPRESS GARDENS BLVD
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City | WINTER HAVEN
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State | FL
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Zip | 33884-6200
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Country | US
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Telephone | 863-318-9966
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Fax |
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Provider Business Mailing Address
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Address Line | 7450 CYPRESS GARDENS BLVD
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City | WINTER HAVEN
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State | FL
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Zip | 33884-6200
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Country | US
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Telephone | 863-318-9966
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVA KAREN BOSWELL
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Credential | O.D.
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Telephone | 863-318-9966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | FLOPC1799
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License Number State | FL
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