Healthcare Provider Details

I. General information

NPI: 1669661203
Provider Name (Legal Business Name): BOYCE A HORNBERGER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 N ALAFAYA TRL STE 103
ORLANDO FL
32826-2945
US

IV. Provider business mailing address

3151 N ALAFAYA TRL STE 103
ORLANDO FL
32826-2945
US

V. Phone/Fax

Practice location:
  • Phone: 407-380-8700
  • Fax: 407-380-7043
Mailing address:
  • Phone: 407-380-8700
  • Fax: 407-380-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberME73563
License Number StateFL

VIII. Authorized Official

Name: DR. BOYCE A HORNBERGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-380-8700