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NPI Code Detail

MEDICARE: DR. BETTE E BOYSEN M.D.

MEDICARE:  DR. BETTE E BOYSEN  M.D.
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
1207Q00000XFamily Medicine PhysicianME16794FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902835457
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BETTE E BOYSEN M.D.
Provider Business Mailing Address
First Line : 2350 SCENIC DR
Second Line :
City : VENICE
State : FL
Zip : 34293-1510
Country : US
Telephone Number : 941-556-3220
Fax Number : 941-955-8214
Provider Business Practice Location Address
First Line : 2350 SCENIC DR
Second Line :
City : VENICE
State : FL
Zip : 34293-1510
Country : US
Telephone Number : 941-584-0041
Fax Number : 941-955-8214
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 08/01/2019

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Directions to “ DR. BETTE E BOYSEN M.D.” Practice Location

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