| NPI | 1104818350 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-08-15 |
| Last Updated | 2019-04-13 |
| Mailing Address | 310 Racetrack Rd Nw Fort Walton Beach, FL 32547-1553 United States Phone: (850) 889-4550 | Fax: (850) 807-5217 📍 View Map |
| Primary Practice Address | 310 Racetrack Rd Nw Ste 100 Fort Walton Beach, FL 32547-1553 United States Phone: (850) 889-4550 | Fax: (850) 889-4549 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 207Y00000X – Otolaryngology | TX | L9631 |
| No | 207YS0012X – Otolaryngology, Sleep Medicine | FL | ME96773 |
| No | 207YS0012X – Otolaryngology, Sleep Medicine | TX | L9631 |
| No | 207YX0602X – Otolaryngology, Otolaryngic Allergy | FL | ME96773 |
| Yes | 207Y00000X – Otolaryngology | FL | ME96773 |
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About NPI 1104818350
Jason Redwood Boole M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1104818350. The primary specialty listed is Otolaryngology. The provider is located in Fort Walton Beach, FL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-08-15. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104818350?
NPI 1104818350 belongs to Jason Redwood Boole M.D., a Otolaryngology in Fort Walton Beach, FL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104818350 active?
The current status of NPI 1104818350 in the NPPES registry is Active. The record was last updated on 2019-04-13.
What specialty is NPI 1104818350?
NPI 1104818350 is classified under the taxonomy Otolaryngology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104818350?
You can verify NPI 1104818350 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104818350?
The primary practice address on file for NPI 1104818350 is 310 Racetrack Rd Nw Ste 100, Fort Walton Beach, FL 32547-1553. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104818350 issued?
NPI 1104818350 was first issued (enumerated) on 2005-08-15. The NPPES record was last updated on 2019-04-13.
Practice Location Map
Jason Redwood Boole is located at 310 Racetrack Rd Nw Ste 100, Fort Walton Beach, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Jason Redwood Boole. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104818350. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Otolaryngology | L9631 | TX |
| Otolaryngology, Sleep Medicine | ME96773 | FL |
| Otolaryngology, Sleep Medicine | L9631 | TX |
| Otolaryngology, Otolaryngic Allergy | ME96773 | FL |
| Otolaryngology | ME96773 | FL |