Healthcare Provider Details

I. General information

NPI: 1497708549
Provider Name (Legal Business Name): ROBERT EDWARD BOYETT SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8955 SW 87 CT SUITE 214
MIAMI FL
33176
US

IV. Provider business mailing address

8955 SW 87TH CT SUITE 214
MIAMI FL
33176
US

V. Phone/Fax

Practice location:
  • Phone: 305-279-5300
  • Fax: 305-598-0371
Mailing address:
  • Phone: 305-279-5300
  • Fax: 305-598-0371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME0012843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: