Provider Demographics
NPI:1073325866
Name:BOYLE, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BOYLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 SW CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2530
Mailing Address - Country:US
Mailing Address - Phone:772-233-7678
Mailing Address - Fax:
Practice Address - Street 1:3678 S CONGRESS AVE STE 2
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3700
Practice Address - Country:US
Practice Address - Phone:561-965-6980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health