Basic Information
| Provider Information | |||||||||
| NPI: | 1548388804 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOYKIN | ||||||||
| FirstName: | RUFUS | ||||||||
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| NameSuffix: | III | ||||||||
| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4017 ANDOVER CAY BLVD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328252704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074924525 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12184 LAKE UNDERHILL RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328255012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073823777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | PT18262 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.