Healthcare Provider Details

I. General information

NPI: 1316853831
Provider Name (Legal Business Name): BOCA RATON FOOT & ANKLE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16244 S MILITARY TRL STE 460
DELRAY BEACH FL
33484-6532
US

IV. Provider business mailing address

16244 S MILITARY TRL STE 460
DELRAY BEACH FL
33484-6532
US

V. Phone/Fax

Practice location:
  • Phone: 561-654-1137
  • Fax:
Mailing address:
  • Phone: 561-206-4746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ANDREW IMMLER
Title or Position: OWNER
Credential: DPM
Phone: 561-654-1137