MEDICARE: DR. ADAM PATRICK BOYLAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH9740	FL

General Provider Information

NPI Number	:	1659509172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM PATRICK BOYLAN D.C.

Provider Business Mailing Address
First Line	:	3208 TAMARIND DR
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32141-6408
Country	:	US
Telephone Number	:	386-341-7649
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 ALEXANDRIA BLVD
Second Line	:	STE. 1010
City	:	OVIEDO
State	:	FL
Zip	:	32765-5548
Country	:	US
Telephone Number	:	407-977-3434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	02/16/2012

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