Paul Bourque, CO

NPI 1669564779 · on the registry since 2006

Practice

Address: 1222 Orange Ave
Ste B
Winter Park, FL 32789
Phone: (407) 740-7772
Fax: (407) 539-1791
Organisation at this address: Specialty Brace & Limb, Inc.
Nancy K Smith Dba Especially For You Mastectomy Boutique
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 174400000X
174400000X
Licence states on file: FL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida