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:
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Health care specialties

SpecialtyCodeLicense #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 5 months 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 1174658116 NPPES
Florida MEDICAID 379728700

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