MEDICARE: MICHAEL LUKE BOYER

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	367500000X	Certified Registered Nurse Anesthetist	9570249	FL
2	367500000X	Certified Registered Nurse Anesthetist	N08259	NY

General Provider Information

NPI Number	:	1689529778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LUKE BOYER

Provider Business Mailing Address
First Line	:	18112 COURTNEY BREEZE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2288
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 W 168TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3720
Country	:	US
Telephone Number	:	212-305-2500
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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