MEDICARE: ELIZABETH DIANE BOYD

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	103K00000X	Behavior Analyst
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1992032114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH DIANE BOYD

Provider Business Mailing Address
First Line	:	3319 MISSION BAY BLVD APT 204
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-5104
Country	:	US
Telephone Number	:	941-258-4059
Fax Number	:

Provider Business Practice Location Address
First Line	:	4541 ALRIX DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-3160
Country	:	US
Telephone Number	:	941-258-4059
Fax Number	:

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

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2009

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Directions to “ ELIZABETH DIANE BOYD ” Practice Location

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