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Individual

COLETTA M BOYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
842 SUNSET LAKE BLVD, SUITE 403, BUILDING B, VENICE, FL 34292-7551
(941) 485-3351
(941) 485-7677
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1153092
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP1153092
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1224574
WELLCARE
FL
01
398532
AVMED
FL
01
48186
UNIVERSAL HEALTHCARE
FL
01
9029745
AETNA
FL
01
P00990542
RAILROAD MEDICARE
FL
01
P937853
OPTIMUM
FL
01
P997003
FREEDOM HEALTH
FL
Enumeration date
08/30/2011
Last updated
12/14/2016
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