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General NPI Number Information
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NPI Number | 1518546449
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Entity Type | Organization
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Legal Business Name | UPSCALE FOOT LLC
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | URB. VALLE VERDE PASEO REAL 1014 SUITE 1
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City | PONCE
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State | PR
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Zip | 00716-0072
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Country | US
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Telephone | 787-501-5941
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8028
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City | BAYAMON
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State | PR
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Zip | 00960-8028
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Country | US
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Telephone | 813-753-6382
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Fax |
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Authorized Official
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Title or Position | ASISTENTE ADMINISTRATIVO
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Name | DYMARIE BURGOS
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Credential |
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Telephone | 787-399-3755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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