Boydstun, Ivy

Boydstun, Ivy is an individual health care provider with primary practice located at 1131 N 35Th Ave Fl 2 , Hollywood FL 33021. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as her primary health care specialty. Boydstun, Ivy can be contacted via phone (954) 265-9344.

Contact Information

Primary practice address
1131 N 35Th Ave Fl 2 Hollywood FL 33021
Phone: (954) 265-9344
Fax: (954) 986-5122
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X ME101007 Florida

Profile Details

NPI number 1285671628
LBN Legal business name Boydstun, Ivy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Mar 17th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285671628 NPPES
Florida MEDICAID 000070000

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