Sylvia Boloczko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME151089 Issued in FL

Practice address

16860 US Highway 441
Mount Dora, FL 32757-6713

Phone

(352) 432-8443

Fax

(844) 388-6186

NPI assigned

Oct 6, 2005

Last updated

Oct 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Medical Associates LLC

  dba VIPcare

  • Primary Care Clinic/Center
  • Lady Lake, FL
  • NPI 1336153709
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1063400893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16860 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576713",
            "telephone_number": "352-432-8443",
            "fax_number": "844-388-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16860 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576713",
            "telephone_number": "352-432-8443",
            "fax_number": "844-388-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOCZKO",
        "first_name": "SYLVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME151089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4543980",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sylviaboloczko@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "5939 N Huron Rd",
            "city": "Oscoda",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487509710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydni Black
• Katherine Yu Blackwell, LCSW
• Emerald Monique Blount
• Natasha Shuntay Boges, BCBA
• Elizabeth Bolano
• Kenneth J Bommarito, D.D.S.
• John Bonner, D.D.S.
• Erin N Booth
• Kimber Anne Bouchard, NP
• Sean Aleksandr Bowers

• Family Medicine Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.