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1508866237
BRIAN BOLIVAR WALLS
MERRITT ISLAND, FL
NPI
1508866237
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: FL ME71812)
Enumeration Date
2005-07-22
Last Update Date
2024-07-03
Business Address
Dr. BRIAN BOLIVAR WALLS MD
500 CROCKETT BLVD
MERRITT ISLAND, FL 32953-5034
Phone number: 321-243-8593
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Mailing Address
Dr. BRIAN BOLIVAR WALLS MD
PO BOX 540033
MERRITT ISLAND, FL 32954-0033
Phone number: 321-243-8593
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