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General NPI Number Information
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NPI Number | 1205026408
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Entity Type | Organization
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Legal Business Name | SOUTH MIAMI FOOT HEALTH CENTER
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 6350 SUNSET DR 2ND FLOOR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4836
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Country | US
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Telephone | 305-667-5683
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Fax |
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Provider Business Mailing Address
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Address Line | 6350 SUNSET DR 2ND FLOOR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4836
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Country | US
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Telephone | 305-667-5683
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH KASHUK
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Credential | DPM
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Telephone | 305-667-5683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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