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General NPI Number Information
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NPI Number | 1457541757
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Entity Type | Organization
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Legal Business Name | LKD PODIATRY INC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 11220 NW 49TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-2771
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Country | US
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Telephone | 954-741-1233
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Fax | 954-344-7029
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Provider Business Mailing Address
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Address Line | 11220 NW 49TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-2771
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Country | US
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Telephone | 954-741-1233
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Fax | 954-344-7029
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER DAGROSSA
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Credential | D.P.M.
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Telephone | 954-741-1233
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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 | PO1976
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License Number State | FL
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