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MINA BOUTROS
NPI 1811790058
Student in an Organized Health Care Education/Training Program in Riverview, FL

Active since March 31, 2025PECOS Enrolled
6901 SIMMONS LOOP, RIVERVIEW, FL 33578(813) 302-8000 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mina Boutros NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINA BOUTROS (NPI 1811790058) is an individual student in an organized health care education/training program in Riverview, Florida and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811790058
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMINA BOUTROS
Location Address6901 SIMMONS LOOPRiverview, FL 33578-9498
Mailing Address6901 Simmons LoopRiverview, FL 33578-9498
Phone(813) 302-8000
Sole ProprietorNo
Enumeration DateMarch 31, 2025
Last NPPES UpdateApril 4, 2025
NPPES CertifiedApril 4, 2025
✔ NPI 1811790058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
6901 SIMMONS LOOP, Riverview, FL 33578
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mina Boutros is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MELISSA MARIE CLINTON PA-C
Physician Assistant (Surgical)
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8070
DR. BRENDAN RAJESH MALIK M.D.
Internal Medicine
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8388
KIMBERLY HAVERS ARNP
Nurse Practitioner
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8400
TAYLOR MACKENZIE LUTHRINGER
Pharmacist
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8000
SAUD MUTHANNA SHAKIR AL-EZZI MD
Student in an Organized Health Care Education/Training Program
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8766
MS. MONIQUE ANNE FELCENLOBEN M.D.
Student in an Organized Health Care Education/Training Program
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8766
JALISA MICHELLE JONES DO, MPH
Student in an Organized Health Care Education/Training Program
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8000
DIGAL NAYAK SHARON JOY DO
Student in an Organized Health Care Education/Training Program
6901 SIMMONS LOOP
RIVERVIEW, FL 33578
Hillsborough County (813) 302-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mina Boutros's NPI number?

The NPI number for Mina Boutros is 1811790058. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Where is Mina Boutros located?

Mina Boutros practices at 6901 Simmons Loop, Riverview, FL 33578. The listed phone number is (813) 302-8000.

What is Mina Boutros's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mina Boutros enrolled in Medicare?

Yes. Mina Boutros is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mina Boutros was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.