Individual
JOSEPH ALFRED BOULAY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6198 52ND ST S, ST PETERSBURG, FL 33715-2405
(727) 410-6399
Mailing address
6198 52ND ST S, ST PETERSBURG, FL 33715-2405
(727) 410-6399
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0040296
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102026500
—
FL
05
—
257246000
—
FL
01
—
LQ519
MEDICARE - FL
FL
Enumeration date
04/20/2006
Last updated
04/10/2026
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