Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mydris Boltze

Individual provider Behavior Technician · NPI 1609412295

Mydris Boltze is a Behavior Technician in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2019.

Licensed in
FL
In the registry since
2019

Practice location Address checks out

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486
Phone: (855) 832-6727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X (FL)

Record details

NPI number1609412295
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 19, 2019
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025
Mailing address7108 S Kanner Hwy, Stuart, FL 34997-7462

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