Provider Demographics
NPI:1972152809
Name:BOYER, IRMA S
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:S
Last Name:BOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S BIRCH RD APT 5C
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1554
Mailing Address - Country:US
Mailing Address - Phone:305-905-3089
Mailing Address - Fax:
Practice Address - Street 1:77 S BIRCH RD APT 5C
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1554
Practice Address - Country:US
Practice Address - Phone:305-905-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider