=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609131754
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN JOSEPH FELDMAN IV M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2012
-----------------------------------------------------
Last Update Date | 11/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10139 NW 31ST ST STE 202
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33065-3908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-755-6100
-----------------------------------------------------
Fax | 954-345-3754
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1608 SE 3RD AVE FL 3
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33316-2564
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-755-6100
-----------------------------------------------------
Fax | 954-345-3754
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | ME153957
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207XX0005X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
-----------------------------------------------------
License Number | ME153957
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------