Healthcare Provider Details

I. General information

NPI: 1427140987
Provider Name (Legal Business Name): PAULA MARIE BOYLE RN,BSN,CWCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD
TAMPA FL
33612-4745
US

IV. Provider business mailing address

2533 VICTARRA CIR
LUTZ FL
33559-3708
US

V. Phone/Fax

Practice location:
  • Phone: 813-078-5956
  • Fax: 813-978-5968
Mailing address:
  • Phone: 813-978-5956
  • Fax: 813-978-5968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number937612
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: