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General NPI Number Information
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NPI Number | 1003879305
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Entity Type | Individual
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Provider Name | EDWIN PRATTS DPM
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Gender | Male
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 2455 W FLAGLER ST SUITE 1
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City | MIAMI
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State | FL
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Zip | 33135-1439
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Country | US
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Telephone | 954-559-1245
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Fax | 305-501-4059
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Provider Business Mailing Address
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Address Line | 18221 SW 22ND ST
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City | MIRAMAR
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State | FL
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Zip | 33029
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Country | US
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Telephone | 954-559-1245
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Fax | 954-437-0979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PO2175
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License Number State | FL
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