Provider Demographics
NPI:1134560709
Name:BOSLEY, DEAN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:MICHAEL
Last Name:BOSLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-416-1082
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:4343 W NEWBERRY RD
Practice Address - Street 2:SUITE 13
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2824
Practice Address - Country:US
Practice Address - Phone:352-332-7770
Practice Address - Fax:352-332-1119
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103936207R00000X
FLME155538208M00000X, 207R00000X
IL036.140831208M00000X
IL036140831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881Medicare Oscar/Certification