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General NPI Number Information
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NPI Number | 1619277647
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE ASSOCIATES OF SOUTH FLORIDA
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 2929 N UNIVERSITY DR STE 106
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City | CORAL SPRINGS
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State | FL
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Zip | 33065
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Country | US
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Telephone | 754-702-2677
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Fax | 754-702-2689
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Provider Business Mailing Address
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Address Line | 2929 N UNIVERSITY DR STE 106
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5047
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Country | US
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Telephone | 754-702-2677
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Fax | 754-702-2689
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. ILIYA BEYLIN
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Credential | DPM
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Telephone | 954-465-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO2983
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License Number State | FL
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