Individual
PAULA JAYNE BOISCLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
4399 35TH ST N, ST PETERSBURG, FL 33714-3722
(727) 525-3959
(727) 527-9695
Mailing address
4399 35TH ST N, ST PETERSBURG, FL 33714-3722
(727) 525-3959
(727) 527-9695
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630114200
—
FL
Enumeration date
05/12/2011
Last updated
05/12/2011
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