Individual
DR. SUZY T BOULES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1701 N MILLS AVE, ORLANDO, FL 32803-1851
(407) 204-7000
(407) 204-1366
Mailing address
6255 W SUNSET BLVD FL 21, LOS ANGELES, CA 90028-7422
(323) 860-5200
(323) 467-7119
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME 92072
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609042563
NPI NUMBER
FL
01
—
ME92072
PROFESSIONAL LICENSE NUMBER
FL
Enumeration date
05/01/2008
Last updated
05/07/2024
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