MEDICARE: BOLAD ARTHRITIS & RHEUMATOLOGY CLINIC, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	ME120763	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215336177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOLAD ARTHRITIS & RHEUMATOLOGY CLINIC, P.A.

Provider Business Mailing Address
First Line	:	1646 33RD ST
Second Line	:	STE 101
City	:	ORLANDO
State	:	FL
Zip	:	32839-8866
Country	:	US
Telephone Number	:	407-409-8118
Fax Number	:	407-264-6562

Provider Business Practice Location Address
First Line	:	1646 33RD ST
Second Line	:	STE 101
City	:	ORLANDO
State	:	FL
Zip	:	32839-8866
Country	:	US
Telephone Number	:	407-409-8118
Fax Number	:	407-264-6562

Authorized Official
Title or Position	:	RHEUMATOLOGIST
Name	:	DR. WALEED A BOLAD
Credential	:	MD
Telephone Number	:	434-466-2996

Provider Enumeration Date	:	08/17/2014
Last Update Date	:	02/15/2016

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