Healthcare Provider Details

I. General information

NPI: 1215127402
Provider Name (Legal Business Name): FOOT & ANKLE SPECIALISTS OF MIAMI BEACH, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 ALTON RD SUITE 710
MIAMI BEACH FL
33140-4558
US

IV. Provider business mailing address

4308 ALTON RD SUITE 710
MIAMI BEACH FL
33140-4558
US

V. Phone/Fax

Practice location:
  • Phone: 305-695-7777
  • Fax: 305-695-7707
Mailing address:
  • Phone: 305-695-7777
  • Fax: 305-695-7707

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: KEVIN BERKOWITZ
Title or Position: PRESIDENT
Credential: DPM
Phone: 305-695-7777