| |
941 Se 1st St, Suite B, Belle Glade, FL 33430-4353 | |
(561) 993-3668 | |
(561) 993-3668 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 941 Se 1st St, Belle Glade, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700015849 | NPI | - | NPPES |
390417200 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | PO0001689 (Florida) | Primary |
213E00000X | Podiatrist | PO0001592 (Florida) | Secondary |
Mailing Address | Practice Location Address |
---|---|
7431 W Atlantic Ave Ste 33, Delray Beach, FL 33446-3505 Ph: (561) 496-6900 | 941 Se 1st St, Suite B, Belle Glade, FL 33430-4353 Ph: (561) 993-3668 |