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General NPI Number Information
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NPI Number | 1528122215
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Entity Type | Organization
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Legal Business Name | BOYNTON HOME FOOT CARE, LLC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/16/2013
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Provider Practice Location Address
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Address Line | 202 ASBURY WAY
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5535
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Country | US
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Telephone | 561-509-9087
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Fax |
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Provider Business Mailing Address
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Address Line | 202 ASBURY WAY
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5535
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Country | US
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Telephone | 561-509-9087
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN LEE FRIEDMAN
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Credential | DPM
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Telephone | 561-509-9087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | PO 3561
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License Number State | FL
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