Danielle A. Boucher, M.D.
Individual provider Active NPI Gynecology Physician · Indialantic, FL
NPI 1508850504 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1508850504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gynecology Physician 207VG0400X
- License
- ME82139 (FL)
- Practice address
- 1220 N Highway A1A Ste 147
Indialantic, FL 32903-2858 - Phone
- (321) 242-8790
- Fax
- (321) 242-1541
- NPI assigned
- Sep 6, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | ME82139 | FL | Yes |
Addresses
Primary practice location
1220 N Highway A1A Ste 147
Indialantic, FL 32903-2858
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 242-8790
Other practice location 1
7125 Murrell Road
Viera, FL 32940-7999
Phone (321) 242-8790
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2599246 | Other | FL | AETNA |
| P01164038 | Other | FL | RR MEDICARE |
| 51172 | Other | FL | FLORIDA BLUE (BCBS OF FL) |
| 5481530001 | Other | FL | CIGNA |
Other names
- Danielle A. Linck
Other providers in Indialantic, FL
- Robert Bisset
- Annmarie Bloch
- Boardwalk Urgent Care
- Joshua Bobineaux
- Susan Darlene Bond
- Marcela Bowie
- Ashley Brackett
- Brevard Spine Center LLC
- Onna Brewer
- Patricia D Burke
All providers in Indialantic, FL · Gynecology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. 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.