Dr Christopher Lee Boudreau, | |
13011 Summerfield Square Dr, Riverview, FL 33578-7402 | |
(220) 981-3374 | |
Not Available |
Full Name | Dr Christopher Lee Boudreau |
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Gender | Male |
Speciality | Physical Medicine & Rehabilitation |
Location | 13011 Summerfield Square Dr, Riverview, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1356082168 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208100000X | Physical Medicine & Rehabilitation | 38351 (Florida) | Primary |
Entity Name | Therapy & Sports Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336247014 PECOS PAC ID: 2062445943 Enrollment ID: O20050912000873 |
Entity Name | Florida Luna Care Physical Therapy Llc |
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Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Entity Identifiers | NPI Number: 1114542032 PECOS PAC ID: 3779991559 Enrollment ID: O20210415001126 |
Mailing Address | Practice Location Address |
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Dr Christopher Lee Boudreau, 7002 Valrie Ln, Riverview, FL 33569-4661 Ph: (813) 495-3166 | Dr Christopher Lee Boudreau, 13011 Summerfield Square Dr, Riverview, FL 33578-7402 Ph: (220) 981-3374 |
Witiza Perez, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 2139 Kings Palace Dr, Riverview, FL 33578 Phone: 813-442-6212 | |
Cheryl Cleveland, PTA Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 12628 Evington Point Dr, Riverview, FL 33579 Phone: 813-416-5135 |