Coletta M Boyle, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP1153092 Issued in FL

Practice address

842 Sunset Lake Blvd
Suite 403, Building B
Venice, FL 34292-7551

Phone

(941) 485-3351

Fax

(941) 485-7677

NPI assigned

Aug 30, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1295016699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 SUNSET LAKE BLVD",
            "address_2": "SUITE 403, BUILDING B",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342927551",
            "telephone_number": "941-485-3351",
            "fax_number": "941-485-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "COLETTA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP1153092",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1153092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9029745",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL HEALTHCARE",
            "identifier": "48186",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00990542",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "398532",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P937853",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P997003",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1224574",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Bowdle, MSN, APRN, PMHNP-BC
• Deborah Jean Bowler, M.A.
• Bruce Allen Boyd, MD
• Lauren Boyd
• Boyer Medical, Inc.
• Bette E Boysen, M.D.
• Tracey Brani
• Julie Anne Braukhoff, LPC
• Carlos Manuel Bravo, PHARM D
• Houston Brice, DMD

• Nurse Practitioner in Venice, FL
• Providers in Venice, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.