# DR. SUZY T BOULES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1609042563
- **Gender:** F
- **Credential:** M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME 92072 | FL | Yes |

## Other

- **Enumeration date:** 05/01/2008
- **Last updated:** 05/07/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1609042563 | NPI NUMBER | FL |
| 01 | — | ME92072 | PROFESSIONAL LICENSE NUMBER | FL |