Boutin, Brandy J.

Boutin, Brandy J. is an individual health care provider with primary practice located at 204 Center St , Gulf Breeze FL 32561-4392. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Boutin, Brandy J. can be contacted via phone (850) 932-5348.

Contact Information

Primary practice address
204 Center St Gulf Breeze FL 32561-4392
Phone: (850) 932-5348
Fax: (850) 932-7740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME98071 Florida

Profile Details

NPI number 1255548129
LBN Legal business name Boutin, Brandy J.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Dec 16th, 2016 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255548129 NPPES
Florida MEDICAID 376274200

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