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General NPI Number Information
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NPI Number | 1003000357
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Entity Type | Organization
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Legal Business Name | PODIATRY NETWORK SOLUTIONS OF LOUISIANA, LLC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 7220 NW 36TH ST SUITE 103
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City | MIAMI
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State | FL
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Zip | 33166-6700
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Country | US
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Telephone | 786-924-0044
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Fax | 305-667-8860
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Provider Business Mailing Address
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Address Line | 7220 NW 36TH ST SUITE 103
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City | MIAMI
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State | FL
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Zip | 33166-6700
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Country | US
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Telephone | 786-924-0044
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Fax | 305-667-8860
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RON JOHNSON
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Credential |
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Telephone | 786-924-0044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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