ALYCIA BUFORD BOUDREAU (NPI# 1649837352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649837352 |
| Entity Type | Individual |
| Full Name | ALYCIA BUFORD BOUDREAU |
| Credential | FNP-C |
| Practice Address |
19605 Morden Blush Dr Lutz FL 33558-9087 |
| Practice Telephone | 8134333929 |
| Mailing Telephone | 8134333929 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2020-01-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11002140 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
19605 MORDEN BLUSH DR |
| City | LUTZ |
| State | FL |
| Zip Code | 33558-9087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801353792 | Oral Maxillofacial and Implant Specialists, LLC | Dentist | 4675 Van Dyke Rd., Lutz, FL 33558 | 2019-02-27 |
| 1780175273 | Elder Services of Central Florida, Inc | Home Health | 17901 Hunting Bow Cir Ste 101, Lutz, FL 33558 | 2018-05-21 |
| 1356843106 | Physicial Medicine & Rehab Consultants | Clinic/Center | 18865 State Road 54 Ste 301, Lutz, FL 33558 | 2018-03-07 |
| 1376905851 | Michelle Renee Story | Contractor | 20921 Haulover Cv. #f6, Lutz, FL 33558 | 2016-03-24 |
| 1992192223 | Melissa Sonia Giblin | Specialist/Technologist, Other | 17535 Darby Ln, Lutz, FL 33558 | 2015-04-24 |
| 1396177739 | Zoe Scripts Laboratory Services LLC | Clinical Medical Laboratory | 4969 Van Dyke Rd., Lutz, FL 33558 | 2013-08-08 |
| 1649617705 | Suzanne Marie Newby | Physician Assistant | 16541 Pointe Village Dr Ste 209, Lutz, FL 33558 | 2013-05-30 |
| 1073889572 | Julie J. Mckean, Lmhc, Ncc, LLC | Counselor | 4929 Van Dyke Road, Lutz, FL 33558 | 2012-03-29 |
| 1750524864 | Sheetal Suryawanshi | Dentist | 17735 Hunting Bow Circle, Lutz, Florida, FL 33558 | 2009-04-20 |
| 1063675478 | Juan J Egas | Physical Medicine & Rehabilitation | 17807 Hunting Bow Cir, Lutz, FL 33558 | 2008-07-07 |
| Find all providers in zip 33558 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881416 | Donald Douglass Jamieson | Nurse Practitioner | 17929 Hunting Bow Cir # Na, Lutz, FL 33558-5378 | 2020-11-08 |
| 1801406194 | Victoria Gonzalez | Nurse Practitioner | 18249 Clear Lake Dr, Lutz, FL 33548-6436 | 2020-08-03 |
| 1740808385 | Jesus Ivan Gonzalez Batista | Nurse Practitioner | 22628 Royal Ridge Ct, Lutz, FL 33549-8781 | 2020-07-09 |
| 1992336440 | Linda Marie Unger | Nurse Practitioner | 2077 Wetland Pt Unit 1201, Lutz, FL 33558-5463 | 2020-02-03 |
| 1629626718 | Amy Marie Algood | Nurse Practitioner | 2507 Chateau Dr, Lutz, FL 33559-4006 | 2019-08-31 |
| 1962982207 | Azeezat Fashola | Nurse Practitioner | 18956 N Dale Mabry Hwy Ste 102, Lutz, FL 33548-4915 | 2018-08-16 |
| 1316424153 | Melissa Rae Waller | Nurse Practitioner | 1860 Bearberry Cir Apt 208, Lutz, FL 33559-8778 | 2018-07-24 |
| 1235621806 | Eliana Hicks | Nurse Practitioner | 2404 Towery Trl, Lutz, FL 33549-3779 | 2018-05-30 |
| 1831643485 | Jennifer Childers | Nurse Practitioner | 24229 Lakerush Ct, Lutz, FL 33559-7330 | 2016-08-11 |
| 1295183739 | Simpliderm, LLC | Nurse Practitioner | 17907 Sparrows Nest Drive, Suite 103, Lutz, FL 33558-8025 | 2016-05-25 |
| Find all providers in LUTZ | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.