Healthcare Provider Details

I. General information

NPI: 1386643286
Provider Name (Legal Business Name): NATIONAL PODIATRIC NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9831 NW 58TH ST SUITE # 127
DORAL FL
33178-2713
US

IV. Provider business mailing address

9831 NW 58TH ST SUITE # 127
DORAL FL
33178-2713
US

V. Phone/Fax

Practice location:
  • Phone: 305-221-6862
  • Fax: 305-221-2033
Mailing address:
  • Phone: 305-221-6862
  • Fax: 305-221-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2910,PO2282,PO2971
License Number StateFL

VIII. Authorized Official

Name: DR. MANUEL J SONE
Title or Position: PRESIDENT
Credential:
Phone: 305-221-6862