Provider Demographics
NPI:1477176477
Name:BOLLINGER, DAVID ANTHONY (REEGT,)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANTHONY
Last Name:BOLLINGER
Suffix:
Gender:M
Credentials:REEGT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 TWELVE OAKS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6972
Mailing Address - Country:US
Mailing Address - Phone:813-591-6316
Mailing Address - Fax:813-591-6350
Practice Address - Street 1:2252 TWELVE OAKS WAY STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6972
Practice Address - Country:US
Practice Address - Phone:813-591-6316
Practice Address - Fax:813-591-6350
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG