Provider Demographics
NPI:1306841986
Name:BOYDMAN, SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:BOYDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 ULMERTON RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-2300
Mailing Address - Country:US
Mailing Address - Phone:727-573-7777
Mailing Address - Fax:954-598-0966
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:BLDG B
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6584
Practice Address - Country:US
Practice Address - Phone:561-495-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003183B207L00000X
FLOS10640207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0493863Medicaid
FL001767800Medicaid
FLCT535WMedicare UPIN
OH0493863Medicaid
OH0611221Medicare PIN