W.P. Booras, M.D., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0040719 Issued in FL

Legal business name

W.P. BOORAS, M.D., P.A.

Practice address

1922 University Blvd S
Jacksonville, FL 32216-8933

Phone

(904) 721-7844

Fax

(904) 727-3597

NPI assigned

Nov 15, 2006

Last updated

Jul 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles H Booras, M.D.NPI 1508824772

Title

President

Phone

(904) 721-7844

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles H Booras, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508824772
  NPD (past) Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1437221033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168933",
            "telephone_number": "904-721-7844",
            "fax_number": "904-727-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168933",
            "telephone_number": "904-721-7844",
            "fax_number": "904-727-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.P. BOORAS, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "BOORAS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-721-7844",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0040719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD",
            "identifier": "080025632",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15776",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Mario Vultaggio Jr., DDS
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• Nancy Kathryn Vynanek, RN
• W.B. Stewart Tigers Athletics Boosters (EWC Sports Medicine)
• Jeffrey Howard Wachholz, M.D.
• John Kelly Wachira, MD
• Noah Zachary Wacker
• Racquel Denise Waddy
• Kadijo Wade-Thomas, MD

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, 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 Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.