Provider Demographics
NPI:1992741128
Name:BOYLE, ANDREW JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:BOYLE
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 1:1345 W BAY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2264
Mailing Address - Country:US
Mailing Address - Phone:727-587-7111
Mailing Address - Fax:727-518-0166
Practice Address - Street 1:1345 W BAY DR STE 301
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2264
Practice Address - Country:US
Practice Address - Phone:727-587-7111
Practice Address - Fax:727-518-0166
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138699207RC0000X
GA073195207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN121353OtherUCARE
MN237A2BOOtherBCBS
MT0051612OtherMT MA
MNG35916Medicare UPIN
MNHP40165OtherHEALTHPARTNERS
MN448018000Medicaid
MN1031490OtherPREFERRED ONE
MN25-00021OtherMEDICA PRIMARY
MN1664850OtherARAZ
MN25-00735OtherMEDICA CHOICE