DR. STEPHEN PATRICK BOLDUC (NPI# 1740233170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740233170 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN PATRICK BOLDUC |
| Credential | M.D. |
| Practice Address |
23 Mack Bayou Loop Suite 200 Santa Rosa Beach FL 32459-2606 |
| Mailing Address |
Po Box 2699 Pensacola FL 32513-2699 |
| Practice Telephone | 8502783920 |
| Practice Fax Number | 8502783919 |
| Mailing Telephone | 8502783920 |
| Mailing Fax Number | 8502783919 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2015-12-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ME121545 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
23 MACK BAYOU LOOP SUITE 200 |
| City | SANTA ROSA BEACH |
| State | FL |
| Zip Code | 32459-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265408397 | Luis Fernando Gomez | Pediatrics | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2606 | 2006-02-28 |
| 1275974909 | Crystal C Tidwell | Pediatrics | 23 Mack Bayou Loop, Ste 200, Santa Rosa Beach, FL 32459-2606 | 2013-07-10 |
| 1861779183 | Christine Fontinel | Nurse Practitioner | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2606 | 2011-11-15 |
| 1184804809 | Tiffany Laine Vroon | Pediatrics | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2606 | 2007-11-09 |
| 1396940227 | Patrick A. Ferry | Internal Medicine | 23 Mack Bayou Loop, Suite 100, Santa Rosa Beach, FL 32459-2606 | 2007-06-20 |
| 1689601338 | Rickey J Viator | Pediatrics | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2604 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740521 | Gary Mcfadyen | Hearing Instrument Specialist | 395 E. Point Washington, Santa Rosa Beach, FL 32459 | 2020-11-04 |
| 1235783218 | Camilla Ruth Chacon | Nurse Practitioner | 4821 Highway 98 West, Suite 104, Santa Rosa Beach, FL 32459 | 2019-07-29 |
| 1942797287 | Lauren Mank | Assistant Behavior Analyst | 67 Hiker St Fl 32459, Santa Rosa Beach, FL 32459 | 2018-04-20 |
| 1740781137 | Imaging Institute LLC | Radiology | 6757 Us Hwy 98 W Ste 301, Santa Rosa Beach, FL 32459 | 2018-02-22 |
| 1023540648 | Emerald Coast Medical Supplies LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 48 Bald Eagle Dr, Santa Rosa Beach, FL 32459 | 2017-04-02 |
| 1215485230 | Tamra Snook | Social Worker | 156 N County Highway 393 Unit 1, Santa Rosa Beach, FL 32459 | 2016-09-19 |
| 1437605730 | Alexandra Armstrong | Physical Therapist | 249 Mack Bayou Loop Ste 101, Santa Rosa Beach, FL 32459 | 2016-08-28 |
| 1386097749 | Itetra Smith | Behavior Technician | 67 Hiker St, Santa Rosa Beach, FL 32459 | 2016-07-20 |
| 1730527086 | Emerald Coast Medical Supplies LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 48 Bald Eagle Drive, Santa Rosa Beach, FL 32459 | 2013-06-10 |
| 1114269768 | Pamela Jean Skaff | Dentist | 101 Lecom Way, Defuniak Springs, FL 32459 | 2013-03-21 |
| Find all providers in zip 32459 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215201595 | Rodney Dixon Dorand | Pediatrics | 530 Blue Mountain Rd, Santa Rosa Beach, FL 32459-5122 | 2012-03-03 |
| 1265408397 | Luis Fernando Gomez | Pediatrics | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2606 | 2006-02-28 |
| 1386638864 | Susanna O Buchholz | Pediatrics | 91 Mack Bayou Loop, Santa Rosa Beach, FL 32459-2604 | 2005-09-09 |
| 1275974909 | Crystal C Tidwell | Pediatrics | 23 Mack Bayou Loop, Ste 200, Santa Rosa Beach, FL 32459-2606 | 2013-07-10 |
| 1528201472 | Prabha Swamy Weiss | Pediatrics | 23 Mack Bayou Loop Ste 100, Santa Rosa Beach, FL 32459 | 2009-04-08 |
| 1184804809 | Tiffany Laine Vroon | Pediatrics | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2606 | 2007-11-09 |
| 1689601338 | Rickey J Viator | Pediatrics | 23 Mack Bayou Loop, Suite 200, Santa Rosa Beach, FL 32459-2604 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134734072 | Megan Anne Watkins | Pediatrics | 2020 Cattleman Rd, Suite 600, Sarasota, FL 34232 | 2020-09-08 |
| 1114530664 | Complex Care of Central Florida, LLC | Pediatrics | 508 Sweetwater Club Cir, Longwood, FL 32779-2131 | 2020-08-25 |
| 1073123931 | Topaz Pediatrics, LLC | Pediatrics | 2513 E Semoran Blvd, Apopka, FL 32703-5835 | 2020-08-05 |
| 1255941688 | Doctors Memorial Health Clinic | Pediatrics | 2910 Hospital Dr Ste B, Bonifay, FL 32425-4268 | 2020-07-31 |
| 1508475815 | Baptist Primary Care Inc | Pediatrics | 520 A1a N Ste 102, Ponte Vedra Beach, FL 32082-2260 | 2020-07-23 |
| 1720603129 | Kids' Corner Pediatrics | Pediatrics | 1114 Bell Shoals Road, Brandon, FL 33511-8813 | 2020-06-11 |
| 1245855063 | Pediatric Associates of Tampa Bay, LLC | Pediatrics | 901 E Bloomingdale Ave # 501, Brandon, FL 33511-8118 | 2020-06-09 |
| 1396369187 | Im Sulzbacher Center for The Homeless, Inc | Pediatrics | 5455 Springfield Blvd, Jacksonville, FL 32208-5166 | 2020-06-08 |
| 1255954855 | Step By Step Ppec Corp | Pediatrics | 8300 Nw 177th St, Hialeah, FL 33015-3645 | 2020-05-19 |
| 1932721107 | Dr. B's Kids, Pa | Pediatrics | 215 Nw 138th Ter Ste 100, Newberry, FL 32669-2090 | 2020-05-11 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA BEACH |
| Zip Code | 32459 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.