DR. LAWANDY FAWZY BOLIS (NPI# 1679722839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679722839 |
| Entity Type | Individual |
| Full Name | DR. LAWANDY FAWZY BOLIS |
| Credential | MD |
| Practice Address |
3231 Mcmullen Booth Rd Safety Harbor FL 34695-6607 |
| Mailing Address |
Po Box 10744 Clearwater FL 33757-8744 |
| Practice Telephone | 7278157207 |
| Practice Fax Number | 7272664951 |
| Mailing Telephone | 7275320002 |
| Mailing Fax Number | 7272664943 |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2017-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME102757 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 000577000 | 05 | |
| FL | BCBS | 78234 | 01 |
| FL | RR MEDICARE | P00807399 | 01 |
| Street Address |
3231 MCMULLEN BOOTH RD |
| City | SAFETY HARBOR |
| State | FL |
| Zip Code | 34695-6607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942282959 | Michael Dominic Bruno | Internal Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2005-11-16 |
| 1255944104 | Moeen Khalil Skilled Nursing Facility Consulting | Internal Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2020-08-28 |
| 1033778048 | Stephanos Nicholas Tsongranis | Nurse Practitioner | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2019-06-12 |
| 1073170163 | Brittany Lauria | Registered Nurse | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2019-05-23 |
| 1922592633 | Ashley A Lair | Nurse Practitioner | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2018-06-15 |
| 1376046896 | Amanda Winslow | Nurse Anesthetist, Certified Registered | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695 | 2018-03-11 |
| 1699275305 | Kimberly Kay Bain | Nurse Practitioner | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2018-02-19 |
| 1831618362 | Maria E Tsambarlis | Physician Assistant | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2017-09-15 |
| 1215467642 | Eric Dietrich Scheck | Nurse Practitioner | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2017-06-18 |
| 1598208530 | Eugenie Anette Newby-stephan | Nurse Practitioner | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2016-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467931071 | Joli Beauchamp | Occupational Therapy Assistant | 1410 Dr Martin Luther King Jr St. North, Safety Harbor, FL 34695 | 2018-08-14 |
| 1912494733 | Bryan Singleton | Occupational Therapist | 1410 Dr. M, Dr Martin Luther King Jr Street North, Safety Harbor, FL 34695 | 2018-04-17 |
| 1639673007 | Jessica Rojas | Occupational Therapy Assistant | 1410 Dr. Martin Luther King St N, Safety Harbor, FL 34695 | 2018-03-21 |
| 1326547365 | Heather Anne Ramous | Nurse Practitioner | 1840 Mease Dr Ste 307, Safety Harbor, FL 34695 | 2018-02-05 |
| 1922531730 | Jessica Robin Sternberg | Physical Therapy Assistant | 1410 Dr. Martin Luther King Jr. Street North, Safety Harbor, FL 34695 | 2017-04-07 |
| 1861863102 | Pamela Guida | Physical Therapy Assistant | 1410 Dr M L King Jr St N, Safety Harbor, FL 34695 | 2015-10-13 |
| 1962888792 | Lauren Ramos | Nurse Practitioner | 1840 Mease Dr., Suite 204, Palm Harbor, FL 34695 | 2015-08-04 |
| 1306285010 | Paulas Madhusudan Vyas | Urology | 1840 Mease Dr Ste 300, Safety Harbor, FL 34695 | 2013-06-17 |
| 1871803643 | Bridget Stirling Tyrka | Contractor | 1045 3rd St N, Safety Harbor, FL 34695 | 2010-10-14 |
| 1326211574 | Helen L. Techler | Audiologist | 583 Main Street, Suite A, Safety Harbor, FL 34695 | 2008-04-09 |
| Find all providers in zip 34695 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821501982 | Winona Louise Werts | Family Medicine | 1803 Briar Creek Blvd, Safety Harbor, FL 34695-4696 | 2017-11-13 |
| 1295077204 | Paul M Zipper | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2013-03-18 |
| 1144596495 | Kalyanchakravarthi Mallela | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2012-03-30 |
| 1356617823 | Stephanie Lynne Yanase | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2012-03-28 |
| 1629348693 | David Languido Jumapao | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2012-01-09 |
| 1821384280 | Daniel J Gordon | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2011-06-23 |
| 1912291238 | Justin Hunt | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2011-06-03 |
| 1154612372 | Joshua B Mandel | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2011-04-21 |
| 1013216563 | Lovekesh Sharma | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695-6607 | 2011-03-23 |
| 1144532177 | Daniel George Firth | Family Medicine | 3231 Mcmullen Booth Rd, Safety Harbor, FL 34695 | 2010-07-07 |
| Find all providers in SAFETY HARBOR | ||||
| City | SAFETY HARBOR |
| Zip Code | 34695 |
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| 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.