| Evander A Boynton Iii, MD | |
|
1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 | |
| (863) 683-7171 | |
| (863) 687-0742 |
| Full Name | Evander A Boynton Iii |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 33 Years |
| Location | 1125 Bartow Rd, Lakeland, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760459770 | NPI | - | NPPES |
| 269082900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | ME-0089123 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lakeland Regional Medical Center | Lakeland, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lakeland Pathologists, Pa | 3274428982 | 6 |
| Entity Name | Lakeland Pathologists, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649220872 PECOS PAC ID: 3274428982 Enrollment ID: O20040220000001 |
| Mailing Address | Practice Location Address |
|---|---|
| Evander A Boynton Iii, MD 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 Ph: (863) 683-7171 | Evander A Boynton Iii, MD 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 Ph: (863) 683-7171 |
Patricia N Moody, M.D. Pathology Medicare: Medicare Enrolled Practice Location: 1125 Bartow Rd, Lakeland, FL 33801 Phone: 863-683-7171 | |
Craig Lariscy, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 1125 Bartow Rd, Suite 101, Lakeland, FL 33801 Phone: 863-683-7171 Fax: 863-687-0742 | |
Dr. Timothy James Dickason, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 1125 Bartow Rd, Ste 101, Lakeland, FL 33801 Phone: 863-683-7171 | |
Edward Garcia, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 1125 Bartow Rd, Suite 101, Lakeland, FL 33801 Phone: 863-683-7171 Fax: 863-687-0742 | |
Dr. Tisha Foster, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3200 Lakeland Hills Blvd, Lakeland, FL 33805 Phone: 863-687-8925 | |
Ricardo E Duque, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 1125 Us Highway 98 S, Suite 101, Lakeland, FL 33801 Phone: 863-683-7171 Fax: 863-687-0742 |