Christina S Bourbon, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA16762 Issued in FL

Practice address

607 S Westland Ave Apt 10
Tampa, FL 33606-2460

Phone

(352) 613-5509

NPI assigned

Apr 1, 2019

Sex

Female

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1477015485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S WESTLAND AVE APT 10",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062460",
            "telephone_number": "352-613-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S WESTLAND AVE APT 10",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062460",
            "telephone_number": "352-613-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBON",
        "first_name": "CHRISTINA",
        "middle_name": "S",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alice Mendez Boullosa, M.S.W., L.M.F.T.
• Eriny Boulos, DMD
• Ryan Matthew Bourdeau, BA
• Katelyn Frances Bourgoin, MS CFSLP
• Jeffrey Donald Bourguignon, D.C.
• Diane Bourlier, DO
• Carla Inez Bourne, M.D.

• Speech-Language Pathologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.