Constantine G Bouchlas, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME58052 Issued in FL

Practice address

2250 Drew St
Clearwater, FL 33765-3305

Phone

(727) 724-5631

Fax

(727) 724-5689

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: constantinebouchlas@fsispine.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Clearwater Orthopaedic ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Clearwater, FL
  • NPI 1306892609
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1073584041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17328",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337620328",
            "telephone_number": "727-724-5631",
            "fax_number": "727-216-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653305",
            "telephone_number": "727-724-5631",
            "fax_number": "727-724-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHLAS",
        "first_name": "CONSTANTINE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME58052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey N Bott, M.D.
• Kyle Botti
• Korean Ann Botts, A.R.N.P.
• Kenneth P Botwin, MD
• Kaitlin Boucher, LCSW
• Vasiliki Boulieris
• Brien M Bourbeau, APRN-C
• Barbara J. Bourland, M. D.
• Tracey R Bourne, L.M.H.C.
• Bassem Ramzy Boutros, RPH

• Physical Medicine & Rehabilitation Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.