Jacqueline Boutrouille MD PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME87029 Issued in FL

Legal business name

JACQUELINE BOUTROUILLE MD PA

Practice address

7880 N University Dr
Ste 303
Tamarac, FL 33321-2124

Phone

(954) 340-3000

Fax

(954) 636-8407

NPI assigned

Jan 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacqueline D Boutrouille, MD

Title

Owner

Phone

(954) 340-3000

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1720325574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7880 N UNIVERSITY DR",
            "address_2": "STE 303",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212124",
            "telephone_number": "954-340-3000",
            "fax_number": "954-636-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7880 N UNIVERSITY DR",
            "address_2": "STE 303",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212124",
            "telephone_number": "954-340-3000",
            "fax_number": "954-636-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE BOUTROUILLE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "BOUTROUILLE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-340-3000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME87029",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "FL",
            "license": "ME87029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268083100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jac Health Mnagement LLC
• Reagan Lauren Jackso9N
• Marsha Jackson, APRN
• Marie-Paule L Jacob-Ampuero, M.D.
• Judith Ann Jacobs, LMFT
• Jersa Jadotte
• Maria Alejandra Jaimes, M.D.
• Lisa-Ann James-Watson
• Janee D. Steinberg, M.D., PA
• Taryn Marie Jaramillo, MSW

• Psychiatry Physician in Tamarac, FL
• Providers in Tamarac, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.