| Boswell Medical Group, P.a. | |
|
333 Se 2nd Ave Ste 2000 Miami FL 33131-2185 | |
| (401) 300-5222 | |
| Not Available |
| Full Name | Boswell Medical Group, P.a. |
|---|---|
| Speciality | Dermatology |
| Location | 333 Se 2nd Ave Ste 2000, Miami, Florida |
| Authorized Official Name and Position | Bryan Wang (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 8324207667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boswell Medical Group, P.a. 333 Se 2nd Ave Ste 2000 Miami FL 33131-2185 Ph: () - | Boswell Medical Group, P.a. 333 Se 2nd Ave Ste 2000 Miami FL 33131-2185 Ph: (401) 300-5222 |
| NPI Number | 1477382620 |
|---|---|
| Provider Enumeration Date | 07/27/2024 |
| Last Update Date | 11/15/2024 |
| Medicare PECOS PAC ID | 4082155882 |
|---|---|
| Medicare Enrollment ID | O20240919004055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477382620 | NPI | - | NPPES |
| Provider Name | Carissa Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20210520001931 |
| Provider Name | Ryan Karmouta |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1316441066 PECOS PAC ID: 0648526509 Enrollment ID: I20241004001547 |
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