Dr. Bouali Frederick Amoli
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
5149 Normandy Blvd Unit 4
Jacksonville
, Florida 32205-4861
Dr. Bouali Frederick Amoli
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
5149 Normandy Blvd Unit 4
Jacksonville
, Florida 32205-4861
(904) 781-1201
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Bouali Frederick Amoli
- 5149 Normandy Blvd Unit 4
- Jacksonville, FL
- Zip : 32205-4861
- Phone : (904) 781-1201
Second Address
- Dr. Bouali Frederick Amoli
- 5149 Normandy Blvd Unit 4
- Jacksonville, FL
- Zip : 32205-4861
- Phone : (904) 781-1201
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN 21029 | FL |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | DRP781 | FL |
| N | 204E00000X | Oral & Maxillofacial Surgeon | ME119684 | FL |
National Provider Identifier
| NPI | 1306073754 |
|---|---|
| Provider Name | Dr. Bouali Frederick Amoli |
| First Address | Jacksonville, FL 32205-4861 |
| Second Address | Jacksonville, FL 32205-4861 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/06/2009 |
| Last Update Date | 23/02/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 012224600 | (05) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.