Healthcare Provider Details

I. General information

NPI: 1952145062
Provider Name (Legal Business Name): MUSHARIB CHAUDHRY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8188 S JOG RD STE 205
BOYNTON BEACH FL
33472-2952
US

IV. Provider business mailing address

8188 S JOG RD STE 205
BOYNTON BEACH FL
33472-2952
US

V. Phone/Fax

Practice location:
  • Phone: 561-752-7481
  • Fax: 407-671-4155
Mailing address:
  • Phone: 561-752-7481
  • Fax: 407-671-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4557
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: