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NPI Code Detail

MEDICARE: RUFUS BOYKIN III PT

MEDICARE: RUFUS BOYKIN III PT
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
12251X0800XOrthopedic Physical TherapistPT18262FL

General Provider Information

NPI Number : 1548388804
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUFUS BOYKIN III PT
Provider Business Mailing Address
First Line : 4017 ANDOVER CAY BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32825-2704
Country : US
Telephone Number : 407-492-4525
Fax Number :
Provider Business Practice Location Address
First Line : 12184 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32825-5012
Country : US
Telephone Number : 407-382-3777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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