Provider Demographics
NPI:1861031742
Name:BOYD, JAKE CHRISTOPHER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAKE
Middle Name:CHRISTOPHER
Last Name:BOYD
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:4725 N FEDERAL HWY # ER
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4603
Mailing Address - Country:US
Mailing Address - Phone:561-801-0877
Mailing Address - Fax:
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-492-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-25
Last Update Date:2020-04-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant