Vivyan Boutros

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RP441765 Issued in PA

Practice address

7205 N Military TRL
West Palm Beach, FL 33410-6413

Phone

(561) 422-5728

NPI assigned

Feb 11, 2022

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1477207116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 HOLLOW DR",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 N MILITARY TRL",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334106413",
            "telephone_number": "561-422-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "VIVYAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "PA",
            "license": "RP441765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolene Bourjolly
• Melpomeni Bourkas
• Patrick Boursiquot, LCSW
• Abanoub Boutros, DC
• Marianne Boutros, PA-C
• Beverly Anne Bowen, DMD
• Tyesha Bowen, AGNP
• Rhonda Bowers
• Madelynn H Bowie
• Casey Gordon Boyer, M.D.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.