Provider Demographics
NPI:1740431477
Name:BOSSOUS, GEORGES JR (MS)
Entity Type:Individual
Prefix:
First Name:GEORGES
Middle Name:
Last Name:BOSSOUS
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 E. COLONIAL DRIVE
Mailing Address - Street 2:STE 305
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4706
Mailing Address - Country:US
Mailing Address - Phone:407-588-8795
Mailing Address - Fax:
Practice Address - Street 1:1516 E COLONIAL DR STE 305
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4732
Practice Address - Country:US
Practice Address - Phone:407-588-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker