Provider Demographics
NPI:1538147384
Name:BOOKER, JAMES J IV (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:BOOKER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:427 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3051
Mailing Address - Country:US
Mailing Address - Phone:863-299-1107
Mailing Address - Fax:863-291-3318
Practice Address - Street 1:427 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3051
Practice Address - Country:US
Practice Address - Phone:863-299-1107
Practice Address - Fax:863-291-3318
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2019-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME91226207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH62595Medicare UPIN