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General NPI Number Information
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NPI Number | 1184620668
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Entity Type | Individual
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Provider Name | FREDERICK E FOEPPEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 3601 SW 160TH AVE SUITE 250
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City | MIRAMAR
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State | FL
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Zip | 33027-6308
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Country | US
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Telephone | 877-866-7123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | SOMERS
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State | NY
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Zip | 10589-0306
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Country | US
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Telephone | 914-276-0880
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Fax | 914-276-0883
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 172144
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME116076
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License Number State | FL
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