Individual
DR. MARYLISE BOUTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D. FRCS
Contact information
Practice address
2950 CLEVELAND CLINIC BLVD, WESTON, FL 33331-3609
(954) 659-5757
Mailing address
16380 S POST RD, APT 102, WESTON, FL 33331-3557
(954) 632-7672
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
TRN15351
FL
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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