Individual provider · NPI-1

Dr. Alexandre Reginald Boulos, MD

Orthopaedic Surgery · Hollywood, FL

NPI number1306338397
StatusActive
Last updated in NPPESSep 18, 2025

Details

NPI
1306338397
Entity type
Individual (NPI-1)
Name
Dr. Alexandre Reginald Boulos
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 5, 2018
Certification date
Sep 18, 2025
Last updated
Sep 18, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic SurgeryA194916CAYes
207X00000X Orthopaedic SurgeryMD19055RI

Practice location

3440 Hollywood Blvd Ste 140
Hollywood, FL 33021-6900

Phone 954-276-9276

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925

Phone 954-275-5501

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