Provider Demographics
NPI:1740281740
Name:BOYER, CASEY GORDON (MD)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:GORDON
Last Name:BOYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19834
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-4834
Mailing Address - Country:US
Mailing Address - Phone:612-369-8805
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 19834
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33416-4834
Practice Address - Country:US
Practice Address - Phone:561-313-1357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0056169207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0470223OtherUNITED HEALTH CARE
FL08282OtherBLUE CROSS OF FLORIDA
FL107737OtherHUMANA CENTER NUMBER
FL107737OtherHUMANA CENTER NUMBER
FL08282Medicare PIN