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1194751255
KENNETH PAUL BOCCACCIO
TAMPA, FL
NPI
1194751255
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 102296)
Enumeration Date
2006-06-23
Last Update Date
2012-01-03
Business Address
KENNETH PAUL BOCCACCIO PA-C
12880 COMMODITY PLACE
TAMPA, FL 33626-3101
Phone number: 813-343-5500
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Mailing Address
KENNETH PAUL BOCCACCIO PA-C
PO BOX 21724
TAMPA, FL 33622-1724
Phone number: 813-343-5500
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