=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467635235
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PODIATRIC ORTHOPEDICS,SURGERY, AND WOUND CARE ASSOCIATES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2007
-----------------------------------------------------
Last Update Date | 12/14/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7942 NW 158TH TER
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016-7111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-295-3154
-----------------------------------------------------
Fax | 305-817-2589
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8004 NW 154TH ST SUITE 390
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016-5814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-295-3154
-----------------------------------------------------
Fax | 305-817-2589
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. GABY KAFIE
-----------------------------------------------------
Credential | D.P.M.
-----------------------------------------------------
Telephone | 786-295-3154
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | PO2919
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------