Omar Bouso, CSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

22-533 Issued in WI

Practice address

6932 SW 18TH CT
Pompano Beach, FL 33068-4328

Phone

(954) 204-2151

NPI assigned

Sep 15, 2022

Last updated

Sep 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1164144275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6932 SW 18TH CT",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330684328",
            "telephone_number": "954-204-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6932 SW 18TH CT",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330684328",
            "telephone_number": "954-204-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSO",
        "first_name": "OMAR",
        "name_prefix": "Mr.",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "22-533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Yvonne Borckardt, RN
• Barbara Ann Bostic
• Rodrigo Botero, BS
• Patricia Bouchereau
• Ralph Bourjolly, O.D.
• Georges Boutin, M.D.
• Joy Monica Rol Bouza, ARNP
• Ashley Bowman
• Elizabeth Bowman, ED.D.
• Lesvia Evelin Bowman

• Surgical Assistant in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Surgical Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.