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General NPI Number Information
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NPI Number | 1114834405
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Entity Type | Individual
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Provider Name | RACE ELIE BOURGEOIS
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Gender | Male
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 8983 OKEECHOBEE BLVD STE 208
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-5145
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Country | US
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Telephone | 561-478-3702
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 TURTLE CREEK BLVD STE 850
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City | DALLAS
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State | TX
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Zip | 75219-4560
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Country | US
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Telephone | 469-694-0660
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 354009
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License Number State | LA
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