Michael D Boehm MD PA

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

ME55585 Issued in FL

Legal business name

MICHAEL D BOEHM MD PA

Practice address

1601 W Reynolds St
Suite 104
Plant City, FL 33563-4748

Phone

(813) 752-4646

Fax

(813) 752-5104

NPI assigned

Mar 3, 2010

Last updated

Aug 9, 2010By 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

Michael Daniel Boehm, MD

Title

Owner / Provider

Phone

(813) 752-4646

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 4

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.

• Elizabeth Margaret Ennis, PA-C

  • Physician Assistant
  • Winter Haven, FL
  • NPI 1063733376
  NPD (past)
• Thomas Alexander Lekavich, PA

  • Medical Physician Assistant
  • Tampa, FL
  • NPI 1063465623
  NPD (past)
• Arlenia Paulino

  • Adult Companion
  • Tampa, FL
  • NPI 1992470983
  NPD (past)
• Latonya Rodgers, ARPN

  • Family Nurse Practitioner
  • Brandon, FL
  • NPI 1487822698
  NPD (past)

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1649593773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W REYNOLDS ST",
            "address_2": "SUITE 104",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634748",
            "telephone_number": "813-752-4646",
            "fax_number": "813-752-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W REYNOLDS ST",
            "address_2": "SUITE 104",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634748",
            "telephone_number": "813-752-4646",
            "fax_number": "813-752-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D BOEHM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "BOEHM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "813-752-4646",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME55585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ3034",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271188500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Metampa, LLC (Miracle Ear Center)
• Metanoia Wellness Care LLC
• Metcare of Florida Inc. (Clinical Care Plant City)
• David Methot, NP
• Miami Beach Medical Consultants, LLC. (Clinical Care Medical Centers)
• Michael S Mathews DMD PA
• J. Robert Miles, M.D.
• Millennium Physician Group LLC
• Andrew James Miller, APRN
• Aaron Nathanial Mills, APRN

• Geriatric Medicine (Internal Medicine) Physician in Plant City, FL
• Providers in Plant City, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.