Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Spencer Blake Bouton, PA-C

Individual provider Physician Assistant · NPI 1699240465

Spencer Blake Bouton, PA-C is a Physician Assistant in Sarasota, Florida. Qualified in 2018, 8 years ago. Practices with Smh Physician Services Inc, a 774-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
8
Licensed in
FL
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1540 S Tamiami Trl Ste 303
Sarasota, FL 34239-2921
Phone: (941) 917-8791
Fax: (941) 917-8793
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9111708 (FL)

Record details

NPI number1699240465
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 9, 2018
Last updated in NPPESMarch 4, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Smh Physician Services Inc — 774 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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