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General NPI Number Information
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NPI Number | 1740645282
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Entity Type | Organization
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Legal Business Name | THE BOYER GROUP
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 4061 PEBBLE BROOKE CIR N
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City | ORANGE PARK
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State | FL
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Zip | 32065-8205
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Country | US
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Telephone | 904-738-0142
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Fax | 904-518-3671
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Provider Business Mailing Address
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Address Line | 4061 PEBBLE BROOKE CIR N
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City | ORANGE PARK
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State | FL
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Zip | 32065-8205
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Country | US
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Telephone | 904-738-0142
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Fax | 904-518-3671
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLENE BOYER
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Credential | BBA, MBA, DOCTORATE,
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Telephone | 904-738-0142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | 207Q0000X
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License Number State | FL
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