Provider Demographics
NPI:1508127002
Name:BOIS, LOUIS BERNADIN CLAUDEL (MD,)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:BERNADIN CLAUDEL
Last Name:BOIS
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:LOUIS
Other - Middle Name:B
Other - Last Name:BOIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:401 W NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5044
Mailing Address - Country:US
Mailing Address - Phone:352-728-4242
Mailing Address - Fax:352-728-4868
Practice Address - Street 1:2525 HIGHWAY 44 W
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3722
Practice Address - Country:US
Practice Address - Phone:301-556-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014444800Medicaid
FL151F5OtherBCBS