Boulting, Edmund C.A.
Boulting, Edmund C.A. is an individual health care provider with primary practice located at 785 Primera Blvd Suite 1031, Lake Mary FL 32746-2124. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Boulting, Edmund C.A. can be contacted via phone (407) 834-8111.Contact Information
Primary practice address
785 Primera Blvd Suite 1031
Lake Mary FL 32746-2124
Phone: (407) 834-8111
Fax: (407) 708-1958
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | ME70127 | Florida |
Profile Details
| NPI number | 1174658116 |
|---|---|
| LBN Legal business name | Boulting, Edmund C.A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Jun 25th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174658116 | NPPES |
| Florida | MEDICAID | 379728700 |
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