| Gerard E. Boutin Phd Pa | |
|
13787 Belcher Rd S 140 Largo FL 33771-4065 | |
| (727) 452-5083 | |
| Not Available |
| Full Name | Gerard E. Boutin Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 13787 Belcher Rd S, Largo, Florida |
| Authorized Official Name and Position | Gerard E. Boutin (PRESIDENT) |
| Authorized Official Contact | 7274525083 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerard E. Boutin Phd Pa 13787 Belcher Rd S 140 Largo FL 33771-4065 Ph: (727) 452-5083 | Gerard E. Boutin Phd Pa 13787 Belcher Rd S 140 Largo FL 33771-4065 Ph: (727) 452-5083 |
| NPI Number | 1124366364 |
|---|---|
| Provider Enumeration Date | 01/23/2013 |
| Last Update Date | 01/23/2013 |
| Medicare PECOS PAC ID | 6507001591 |
|---|---|
| Medicare Enrollment ID | O20130321000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124366364 | NPI | - | NPPES |
| Provider Name | Gerard E Boutin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083749386 PECOS PAC ID: 2466416169 Enrollment ID: I20041112000691 |
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