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Contact Information

SHONDELL M BOUIE, MD
110 LONGWOOD AVE
ROCKLEDGE, FL32955-2828
 Phone: 321-636-2211
 Fax: 321-633-7085
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for SHONDELL M BOUIE · (Female)

NPI Number 1982826806
Status Active
Credentials MD
Entity Individual
Enumeration date 05/02/2007
Last updated 06/20/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # ME104881
  • FL Medicaid 001223400
Hospital affiliation(s)
  • WUESTHOFF MEDICAL CENTER ROCKLEDGE - (Acute Care)
    110 LONGWOOD AVE
    ROCKLEDGE, FL 32955
  • WUESTHOFF MEDICAL CENTER - MELBOURNE - (Acute Care)
    250 NORTH WICKHAM ROAD
    MELBOURNE, FL 32935
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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