Individual
CAREY D BOUDREAU JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0077
Mailing address
PO BOX 13811, PHILADELPHIA, PA 19101-3811
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA192
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009792900
—
FL
Enumeration date
10/02/2013
Last updated
11/01/2013
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