Most Relevant Information
Provider Data
| NPI Number: | 1003518754 |
| Provider Name: | RAOUL RUDOLPH BOTHA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/20/2023 |
| Last Updated: | 03/20/2023 |
Provider Practice Location
201 14TH ST SW
LARGO
FL
337703133
Practice Location Phone/Fax
| Phone: | 7275885704 |
| Fax: |
Provider Mailing Location
201 14TH ST SW
LARGO
FL
337703133
Provider Mailing Phone/Fax
| Phone: | 7275885704 |
| Fax: |