Healthcare Provider Details

I. General information

NPI: 1710150602
Provider Name (Legal Business Name): JOSEPH N. URICCHIO, DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 PGA BLVD STE 101
PALM BEACH GARDENS FL
33418-3829
US

IV. Provider business mailing address

5602 PGA BLVD SUITE 101
PALM BEACH GARDENS FL
33418-3829
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-6444
  • Fax: 561-627-3572
Mailing address:
  • Phone: 561-627-6444
  • Fax: 561-627-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO0001641
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO0001641
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO0001641
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO0001641
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH N. URICCHIO
Title or Position: PHYSICIAN/OWNER
Credential: DPM, PA
Phone: 561-627-6444