Bouie, Shondell M
Bouie, Shondell M is an sole proprietor health care provider with primary practice located at 110 Longwood Ave , Rockledge FL 32955-2828. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Bouie, Shondell M can be contacted via phone (321) 636-2211.Contact Information
Primary practice address
110 Longwood Ave
Rockledge FL 32955-2828
Phone: (321) 636-2211
Fax: (321) 633-7085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | ME104881 | Florida |
Profile Details
| NPI number | 1982826806 |
|---|---|
| LBN Legal business name | Bouie, Shondell M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 2nd, 2007 |
| Last updated | Jun 20th, 2013 - about 11 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 | 1982826806 | NPPES |
| Florida | MEDICAID | 001223400 |
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