Wanda M Boote MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

53607 Issued in FL

Legal business name

WANDA M BOOTE MD PA

Practice address

2060 5TH Ave N
St Petersburg, FL 33713-8012

Phone

(727) 895-3376

Fax

(727) 362-3376

NPI assigned

Oct 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wanda M Boote, MDNPI 1063517050

Title

Owner/President

Phone

(727) 895-3376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8834/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wanda M Boote, MD

  • Dermatology Physician
  • St Petersburg, FL
  • NPI 1063517050
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1366639569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138012",
            "telephone_number": "727-895-3376",
            "fax_number": "727-362-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138012",
            "telephone_number": "727-895-3376",
            "fax_number": "727-362-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDA M BOOTE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "BOOTE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "727-895-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "53607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Sue Walton, APRN
• Janice Walton
• Tiffanie Walton
• Xiaoming Shawn Wan, M.D.
• Areerat Wancowicz
• Danielle Marie Wanek, PT, DPT
• De an Wang, ARNP
• Jun Chih Wang, M.D.
• Shannon Wang
• Warby Parker Inc.

• Specialist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.