DR. BOUALI FREDERICK AMOLI


Address: 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861
Phone: 9047811201

DR. BOUALI FREDERICK AMOLI (NPI# 1306073754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306073754
Entity Type Individual
Full Name DR. BOUALI FREDERICK AMOLI
Credential D.M.D. M.D.
Practice Address 5149 Normandy Blvd Unit 4
Jacksonville
FL 32205-4861
Practice Telephone 9047811201
Mailing Telephone 9047811201
Enumeration Date 2009-06-12
Last Update Date 2015-02-23
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
DN 21029 FL Dental Providers
N 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
DRP781 FL Dental Providers
N 204E00000X Oral & Maxillofacial Surgery ME119684 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 012224600 05

Office Location

Street Address 5149 NORMANDY BLVD UNIT 4
City JACKSONVILLE
State FL
Zip Code 32205-4861

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235612730 Siraj K Asadi Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2018-09-11
1982057444 Akhil Dubey Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2016-07-20
1336591452 Jay St Charles II Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2016-07-13
1619329570 Grettel Recillez Lopez Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2016-07-05
1841673126 Joseph E. Smillie Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2015-07-03
1245611342 Sebastien Murphy Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2015-06-15
1720496144 Deshaydia Boykin Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2014-07-29
1740544972 Toni-ann Hylton Mayembe Dentist 5149 Normandy Blvd Unit 4, Jacksonville, FL 32205-4861 2012-07-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003466830 Brandon Neil Hillard Registered Nurse 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 2019-09-13
1720436363 Ericka Sampson Massage Therapist 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 2016-05-24
1578921631 Northstar Counseling Counselor 1672 Pershing Rd, Jacksonville, FL 32205 2016-02-04
1649645144 Magaly Perez-cruz Speech-Language Pathologist 4101-1 College Street, Jacksonville, FL 32205 2015-12-09
1639448723 First Choice Adult Daycare and Home Health Ca Specialist 5336 Quan Drive, Jacksonville, FL 32205 2011-12-20
1437434222 Christopher Styer Pharmacist 654 Casset Ave, Jacksonville, FL 32205 2011-10-12
1871827279 April Marie Felton Nurse Practitioner 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 2009-10-01
1922244821 Danielle Marie Sergent Physical Therapist 5222 Lenox Ave., Jacksonville, FL 32205 2008-12-23
1427181775 Lapp & Associates Behavioral Counselind Ctr Counselor 931 Cassat Avenue, Jacksonville, FL 32205 2007-03-14
1629143326 Elias Moussa Sargi Dentist 2700 Riverside Avenue, Ste 10, Jacksonville, FL 32205 2006-11-21
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154760411 Tyler J Holley Dentist University of Florida- Jacksonville, 653-1 West 8th Street, Jacksonville, FL 32209 2013-06-20
1851602734 Carlo Enrico Guevara Dentist 4540 Southside Blvd Ste 1001, Jacksonville, FL 32216-5495 2010-06-25
1154555035 Salam Omar Salman Dentist 653 W. 8th Street, Uf - Jacksonville Dept. of Oral & Maxillofacial Surgery, Jacksonville, FL 32209 2009-05-07
1316151301 Scott Roberts Sklenicka Dentist 2511 Saint Johns Bluff Rd S, Suite 207, Jacksonville, FL 32246-2346 2007-05-09
1851417406 North Florida Oral & Facial Surgery, P.a. Dentist 11481 Old Saint Augustine Rd Ste 203, Jacksonville, FL 32258-1475 2007-03-22
1992832059 Vanni Russ Strenta Dentist 3914 Blanding Blvd, Jacksonville, FL 32210-5413 2007-02-27
1184760480 Gregory Joseph Groshan Dentist 3007 Hartley Rd, Jacksonville, FL 32257-6201 2007-01-30
1477606267 Gregory W Hartley Dentist 4181 Southpoint Dr E, Suite 200, Jacksonville, FL 32216-0993 2007-01-18
1366591265 Pairot Tayapongsak Dentist 7101 Normandy Blvd, Jacksonville, FL 32205-6211 2007-01-09
1578622908 Jason Lee Dentist 13820 Old St Augustine Rd, Suite 105, Jacksonville, FL 32258 2006-12-08
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 32205

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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