Healthcare Provider Details

I. General information

NPI: 1699572230
Provider Name (Legal Business Name): LUCHANE BOYD PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 SW FEDERAL HWY
STUART FL
34994
US

IV. Provider business mailing address

12264 ROYAL PALM BLVD
CORAL SPRINGS FL
33065-3288
US

V. Phone/Fax

Practice location:
  • Phone: 754-422-9272
  • Fax:
Mailing address:
  • Phone: 754-422-9272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: