DR. AXEL BOUCHARD (NPI# 1962889139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962889139 |
| Entity Type | Individual |
| Full Name | DR. AXEL BOUCHARD |
| Credential | PHD |
| Practice Address |
13099 S Cleveland Ave Ste 300 Fort Myers FL 33907-3835 |
| Practice Telephone | 2399361336 |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2019-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY10473 | FL | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PY10473 | FL | Behavioral Health & Social Service Providers |
| Street Address |
13099 S CLEVELAND AVE STE 300 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907-3835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598389140 | Philip Curtis Klineburger | Psychologist | 13099 S Cleveland Ave Ste 300, Fort Myers, FL 33907-3835 | 2020-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457491714 | Rafael Lopez | Clinical Neuropsychologist | 2180 W 1st St, Suite 202, Fort Myers, FL 33901-3222 | 2007-02-07 |
| 1740376227 | Anne Marie Wells | Clinical Neuropsychologist | 2740 Oak Ridge Ct Ste 304, Fort Myers, FL 33901-9371 | 2006-10-04 |
| 1508971037 | Mabel Lopez | Clinical Neuropsychologist | 10175 6 Mile Cypress Pkwy Ste 3, Fort Myers, FL 33966-6993 | 2006-08-21 |
| 1831119551 | Robert B Silver | Clinical Neuropsychologist | 4461 Camino Real Way, Fort Myers, FL 33966-1019 | 2006-07-19 |
| 1457631525 | Silver Psychology Center, Inc. | Clinical Neuropsychologist | 4461 Camino Real Way, Fort Myers, FL 33966-1019 | 2011-08-22 |
| 1053625939 | David E Cox | Clinical Neuropsychologist | 2776 Cleveland Ave, Suite 814, Fort Myers, FL 33901-5864 | 2010-08-03 |
| 1114107232 | David S Geiser | Clinical Neuropsychologist | 1950 Courtney Dr, Ste 2, Fort Myers, FL 33901-9034 | 2007-11-06 |
| 1205918547 | Joann R Agress | Clinical Neuropsychologist | 2740 Oak Ridge Ct Ste 304, Fort Myers, FL 33901-9371 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512831 | Joshua Rooks, Phd, LLC | Clinical Neuropsychologist | 7328 Jacaranda Ln, Miami Lakes, FL 33014-2670 | 2020-09-09 |
| 1457978991 | Renew Psychiatric Care, LLC | Clinical Neuropsychologist | 3170 N Federal Hwy Ste 206b, Lighthouse Point, FL 33064-6720 | 2020-07-01 |
| 1871110460 | Thoughtwise LLC | Clinical Neuropsychologist | 2840 Remington Green Cir Ste 3, Tallahassee, FL 32308-1518 | 2020-06-29 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1124667795 | Jennifer Ann Barton | Clinical Neuropsychologist | 3411 Day Ave, Miami, FL 33133-5030 | 2019-12-31 |
| 1952947434 | Dagmar E Nunez | Clinical Neuropsychologist | 1351 Seagrape Cir, Weston, FL 33326-2726 | 2019-11-20 |
| 1821632779 | Joshua Daniel Rooks | Clinical Neuropsychologist | 6520 Miami Lakeway S, Miami Lakes, FL 33014-2747 | 2019-11-04 |
| 1427605088 | Global Wellness LLC | Clinical Neuropsychologist | 1560 Sawgrass Corporate Parkway #447, Sunrise, FL 33323 | 2019-08-19 |
| 1528627882 | Anchor Multispecialty Group | Clinical Neuropsychologist | 850 S Palafox St Unit 103, Pensacola, FL 32502-5983 | 2019-06-11 |
| 1639736473 | Aldrich Chan | Clinical Neuropsychologist | 2601 Sw 37th Ave Ste 703, Coral Gables, FL 33133-2750 | 2019-05-28 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
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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.