Provider Demographics
NPI:1659509172
Name:BOYLAN, ADAM PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:PATRICK
Last Name:BOYLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 TAMARIND DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-6408
Mailing Address - Country:US
Mailing Address - Phone:386-341-7649
Mailing Address - Fax:
Practice Address - Street 1:425 ALEXANDRIA BLVD
Practice Address - Street 2:STE. 1010
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5548
Practice Address - Country:US
Practice Address - Phone:407-977-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor