Brendan Tyler Boudreau, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9122431 Issued in FL

Practice address

14881 Draft Horse LN
Wellington, FL 33414-1064

Phone

(561) 797-7988

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1255245619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14881 DRAFT HORSE LN",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334141064",
            "telephone_number": "561-797-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14881 DRAFT HORSE LN",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334141064",
            "telephone_number": "561-797-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "BRENDAN",
        "middle_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9122431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Borton
• Steven Borzak, M.D.
• Kristina Bosch
• Jaelle Bosquet, RN
• Jayme Bouck
• Kari Kay Bouldin, LMFT
• Stacea N Bowen, MD
• Boynton Mental Health LLC
• Taneka Renee Bradford
• Kayce Bramble, AUD

• Physician Assistant in Wellington, FL
• Providers in Wellington, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.