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NPI Code Detail

MEDICARE: EVA KAREN BOSWELL O.D.P.A

MEDICARE: EVA KAREN BOSWELL O.D.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
1152W00000XOptometristFLOPC1799FL

General Provider Information

NPI Number : 1801217971
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVA KAREN BOSWELL O.D.P.A
Provider Business Mailing Address
First Line : 7450 CYPRESS GARDENS BLVD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-6200
Country : US
Telephone Number : 863-318-9966
Fax Number :
Provider Business Practice Location Address
First Line : 7450 CYPRESS GARDENS BLVD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-6200
Country : US
Telephone Number : 863-318-9966
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. EVA KAREN BOSWELL
Credential : O.D.
Telephone Number : 863-318-9966
Provider Enumeration Date : 12/17/2013
Last Update Date : 12/17/2013

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