| Bo Wlmc LLC | |
|
6100 Greenland Rd Ste 301 Jacksonville FL 32258-2626 | |
| (904) 467-4431 | |
| (904) 615-9966 |
| Full Name | Bo Wlmc LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 6100 Greenland Rd Ste 301, Jacksonville, Florida |
| Authorized Official Name and Position | Iren Ortiz Ramirez (OWNER) |
| Authorized Official Contact | 9044674431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bo Wlmc LLC 6100 Greenland Rd Ste 301 Jacksonville FL 32258-2626 Ph: (904) 467-4431 | Bo Wlmc LLC 6100 Greenland Rd Ste 301 Jacksonville FL 32258-2626 Ph: (904) 467-4431 |
| NPI Number | 1073201638 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/01/2023 |
| Certification Date | 05/01/2023 |
| Medicare PECOS PAC ID | 5193184257 |
|---|---|
| Medicare Enrollment ID | O20230707000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073201638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Iren Ortiz Ramirez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295140846 PECOS PAC ID: 7012274038 Enrollment ID: I20171129003483 |
| Provider Name | Jose Enrique Bird-jimenez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871979732 PECOS PAC ID: 3173854023 Enrollment ID: I20191008002682 |
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