Healthcare Provider Details

I. General information

NPI: 1164734141
Provider Name (Legal Business Name): NATHAN KFIR DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 E HALLANDALE BEACH BLVD SUITE A
HALLANDALE BEACH FL
33009-4416
US

IV. Provider business mailing address

3401 N COUNTRY CLUB DR # 618
AVENTURA FL
33180-1700
US

V. Phone/Fax

Practice location:
  • Phone: 954-456-2220
  • Fax: 954-456-2240
Mailing address:
  • Phone: 305-467-3413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO 3388
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberPO 3388
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO 3388
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberPO 3388
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPO 3388
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO 3388
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO 3388
License Number StateFL

VIII. Authorized Official

Name: DR. NATHAN KFIR
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 305-467-3413