Todd Vincent Boicourt
Individual provider Active NPI Certified Registered Nurse Anesthetist · Edgewater, FL
NPI 1104883388 · NPPES record last updated Apr 24, 2020
Key facts
- NPI
- 1104883388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- ARNP1965462 (FL)
- Practice address
- 2928 Oak TRL
Edgewater, FL 32141-6963 - Phone
- (321) 356-9688
- NPI assigned
- Apr 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | ARNP1965462 | FL | Yes |
Addresses
Primary practice location
2928 Oak TRL
Edgewater, FL 32141-6963
Mailing address
PO Box 391118
Deltona, FL 32739-1118
Phone (386) 847-8061
Other practice location 1
601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 667-0004 ext. 141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300827400 | Medicaid | FL | |
| G2740 | Other | FL | BCBS |
Other providers in Edgewater, FL
- Jeffrey R Berner
- Leslie R Betts
- Bhi of Central Florida Corporation
- Noah Benjamin Bigman
- Regina A. Blanke
- Brilliance Living Corporation
- Joshua Budvarson
- Anne Butler
- Rene Callanta
- Larry Cameron
All providers in Edgewater, FL · Certified Registered Nurse Anesthetist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.