Healthcare Provider Details

I. General information

NPI: 1609991041
Provider Name (Legal Business Name): LB PODIATRY FOOT & ANKLE HEALTH CENTER OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 LINTON BLVD SUITE 301E
DELRAY BCH FL
33445-6500
US

IV. Provider business mailing address

4800 LINTON BLVD SUITE 301E
DELRAY BCH FL
33445-6500
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-5757
  • Fax: 561-865-2225
Mailing address:
  • Phone: 561-499-5757
  • Fax: 561-865-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: KENNETH D POSS
Title or Position: OWNER
Credential: DPM
Phone: 561-499-5757