Mary Rose Boehm MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME88288 Issued in FL

Legal business name

MARY ROSE BOEHM MD PA

Practice address

200 E Highland Ave
Clermont, FL 34711-2582

Phone

(352) 242-1430

Fax

(352) 242-1452

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Rose Boehm, MDNPI 1770674715

Title

President

Phone

(352) 242-1430

Specialties & licenses 1

Addresses

Tax ID family

Mary Rose Boehm MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mary Rose Boehm MD PA

  • Internal Medicine Physician
  • Clermont, FL
  • NPI 1053402156
  NPD tax ID

Locations

Practitioners 1

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

• Mary Rose Boehm, MD

  • Internal Medicine Physician
  • Clermont, FL
  • NPI 1770674715
  NPD Authorized official

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972708162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E HIGHWAY 50",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113164",
            "telephone_number": "352-242-1430",
            "fax_number": "352-242-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E HIGHLAND AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112582",
            "telephone_number": "352-242-1430",
            "fax_number": "352-242-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ROSE BOEHM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOEHM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-242-1430",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME88288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana Martinez
• Alec John Martinez, DPT
• Stephanie Martinez
• Amanda Marie Marty
• Mary Rose Boehm MD PA
• Eric Mason, PA
• Kaydee Mae Matherly, RBT
• Anish Mathew, RPH
• Thomas Sunil Mathew, MD
• Brittany Hall Matos, PHARMD

• Primary Care Clinic/Center in Clermont, FL
• Providers in Clermont, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.