Healthcare Provider Details

I. General information

NPI: 1205853009
Provider Name (Legal Business Name): PALM BEACH FAMILY FOOT CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 JOG ROAD SUITE #110
DELRAY BEACH FL
33446-2164
US

IV. Provider business mailing address

15300 JOG ROAD SUITE #110
DELRAY BEACH FL
33446-2164
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-9066
  • Fax: 561-498-9068
Mailing address:
  • Phone: 561-498-9066
  • Fax: 561-498-9068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberP02926
License Number StateFL

VIII. Authorized Official

Name: MR. BRIAN S. FRENCHMAN
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 561-498-9066