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NPI Code Detail

MEDICARE: JULIE BOYLE BCBA, ITDS

MEDICARE: JULIE BOYLE BCBA, ITDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist
2103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306052857
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE BOYLE BCBA, ITDS
Provider Business Mailing Address
First Line : 1920 SPANISH OAKS DR S
Second Line :
City : PALM HARBOR
State : FL
Zip : 34683-6642
Country : US
Telephone Number : 727-282-3234
Fax Number : 727-213-6246
Provider Business Practice Location Address
First Line : 12413 WHITE BLUFF RD
Second Line :
City : HUDSON
State : FL
Zip : 34669-5016
Country : US
Telephone Number : 727-741-3405
Fax Number : 727-213-6246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 05/01/2013

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