MEDICARE: PILAR BOYD PAA

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
1	367H00000X	Anesthesiologist Assistant	12508	GA
2	367H00000X	Anesthesiologist Assistant	75000138A	IN
3	367H00000X	Anesthesiologist Assistant	AA683	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1669135950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PILAR BOYD PAA

Provider Business Mailing Address
First Line	:	1775 W HIBISCUS BLVD STE 215
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-2627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 HICKORY ST
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-3224
Country	:	US
Telephone Number	:	321-837-3820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2021
Last Update Date	:	05/27/2026

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Directions to “ PILAR BOYD PAA” Practice Location

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