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General NPI Number Information
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NPI Number | 1184925521
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Entity Type | Organization
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Legal Business Name | LOWER EXTREMITY CARE, L.L.C.
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 330 SW 27TH AVE STE 403
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City | MIAMI
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State | FL
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Zip | 33135-2967
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Country | US
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Telephone | 305-517-3771
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Fax | 305-517-3455
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Provider Business Mailing Address
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Address Line | PO BOX 430764
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City | SOUTH MIAMI
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State | FL
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Zip | 33243-0764
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Country | US
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Telephone | 305-301-0005
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. EDWARD GONZALEZ
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Credential | D.P.M.
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Telephone | 305-301-0005
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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 | PO3451
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License Number State | FL
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