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General NPI Number Information
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NPI Number | 1588633572
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Entity Type | Organization
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Legal Business Name | MITCHELL BERNKNOPF DPM PA
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 1367 S MILITARY TR
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442
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Country | US
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Telephone | 954-427-3668
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Fax | 954-427-2319
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Provider Business Mailing Address
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Address Line | 9805 MAJORCA PL
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City | BOCA RATON
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State | FL
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Zip | 33434
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Country | US
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Telephone | 954-427-3668
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Fax | 954-427-2319
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Authorized Official
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Title or Position | PRESIDENT
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Name | MITCHELL BERNKNOPF
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Credential | DPM
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Telephone | 954-427-3668
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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 | P02707
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License Number State | FL
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