Boutrouille, Jacqueline D
Boutrouille, Jacqueline D is an sole proprietor health care provider with primary practice located at 7880 N University Dr Suite 303, Tamarac FL 33321-2124. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Boutrouille, Jacqueline D can be contacted via phone (954) 340-3000.Contact Information
Primary practice address
7880 N University Dr Suite 303
Tamarac FL 33321-2124
Phone: (954) 340-3000
Fax: (954) 636-8407
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME 87029 | Florida |
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | ME 87029 | Florida |
Profile Details
| NPI number | 1447295886 |
|---|---|
| LBN Legal business name | Boutrouille, Jacqueline D |
| Credentials | M.D., P.A. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 19th, 2006 |
| Last updated | Jan 11th, 2013 - about 12 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 | 1447295886 | NPPES |
| Florida | MEDICAID | 268083100 |
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