Individual
MR. DONALD BOULANGER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
3911 GOLF PARK LOOP, SUITE 105, BRADENTON, FL 34203-3453
(941) 756-1003
(941) 756-6003
Mailing address
3731 CHERRY ST NE, ST PETERSBURG, FL 33704-1523
(941) 756-1003
(941) 756-6003
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y2902F
BCBS
FL
Enumeration date
02/02/2006
Last updated
07/09/2007
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