Provider Demographics
NPI:1083305783
Name:BOYD, BENJAMIN C (MS, RMFTI)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:C
Last Name:BOYD
Suffix:
Gender:M
Credentials:MS, RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 SW 79TH AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1447
Mailing Address - Country:US
Mailing Address - Phone:608-289-8330
Mailing Address - Fax:
Practice Address - Street 1:4306 W BROWARD BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3755
Practice Address - Country:US
Practice Address - Phone:954-372-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3888106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist