Dr Kimberly Bougoulias, MD - Medicare Pediatrics in Lake Mary, FL

Dr Kimberly Bougoulias, MD is a medicare enrolled "Pediatrics" physician in Lake Mary, Florida. Her current practice location is 725 Rodel Cv, Lake Mary, Florida. You can reach out to her office (for appointments etc.) via phone at (407) 302-3130.

Dr Kimberly Bougoulias is licensed to practice in Florida (license number ME61498) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457342453.

Contact Information

Dr Kimberly Bougoulias, MD
725 Rodel Cv,
Lake Mary, FL 32746-4859
(407) 302-3130
(407) 302-3132



Physician's Profile

Full NameDr Kimberly Bougoulias
GenderFemale
SpecialityPediatrics
Location725 Rodel Cv, Lake Mary, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1457342453
  • Provider Enumeration Date: 10/31/2005
  • Last Update Date: 05/18/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 1759501232
  • Enrollment ID: I20141003002144

Medical Identifiers

Medical identifiers for Dr Kimberly Bougoulias such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457342453NPI-NPPES
375490100MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics ME61498 (Florida)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kimberly Bougoulias is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kimberly Bougoulias, MD
725 Rodel Cv,
Lake Mary, FL 32746-4859

Ph: (407) 302-3130
Dr Kimberly Bougoulias, MD
725 Rodel Cv,
Lake Mary, FL 32746-4859

Ph: (407) 302-3130

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Pediatrics Doctors in Lake Mary, FL

Dr. Karen J Hillock, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 410 Waymont Ct, Lake Mary, FL 32746
Phone: 407-323-3550    Fax: 407-322-6127
Kacie Noelle Lutz, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 735 Primera Blvd, Suite #135, Lake Mary, FL 32746
Phone: 407-321-0085    Fax: 407-328-7658
Dr. Mitchell W. Madden, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 725 Rodel Cv, Lake Mary, FL 32746
Phone: 407-302-3130    Fax: 407-302-3132
Sarah C Li, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 410 Waymont Ct, Lake Mary, FL 32746
Phone: 407-323-3550    Fax: 407-330-5962
Dr. Aileen J. Field, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 725 Rodel Cv, Lake Mary, FL 32746
Phone: 407-302-3130    Fax: 407-302-3132
Dr. Jiby Oommen George, MD FAAP
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 735 Primera Blvd Ste 135, Lake Mary, FL 32746
Phone: 407-321-0085    

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