Walls, Brian Bolivar
Walls, Brian Bolivar is an individual health care provider with primary practice located at 500 Crockett Blvd , Merritt Island FL 32953-5034. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Walls, Brian Bolivar can be contacted via phone (321) 243-8593.Contact Information
Primary practice address
500 Crockett Blvd
Merritt Island FL 32953-5034
Phone: (321) 243-8593
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME71812 | Florida |
Profile Details
| NPI number | 1508866237 |
|---|---|
| LBN Legal business name | Walls, Brian Bolivar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2005 |
| Last updated | Jul 3rd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508866237 | NPPES |
| Florida | MEDICAID | 251358700 |
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