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NPI Code Detail

MEDICARE: BARUN KIM BOUVIA

MEDICARE: BARUN KIM BOUVIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS61079FL

General Provider Information

NPI Number : 1821604299
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARUN KIM BOUVIA
Provider Business Mailing Address
First Line : 13880 TOWNE PLACE BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32837-3345
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13880 TOWNE PLACE BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32837-3345
Country : US
Telephone Number : 407-857-4548
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2020
Last Update Date : 09/21/2020

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Directions to “ BARUN KIM BOUVIA ” Practice Location

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