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General NPI Number Information
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NPI Number | 1932353372
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FOOT & ANKLE SURGERY PLLC
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 550 HERITAGE DR STE 140
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City | JUPITER
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State | FL
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Zip | 33458-3033
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Country | US
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Telephone | 561-799-0857
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Fax |
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Provider Business Mailing Address
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Address Line | 550 HERITAGE DR STE 140
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City | JUPITER
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State | FL
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Zip | 33458-3033
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Country | US
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Telephone | 561-799-0857
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. LILY PAN-PERKINS
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Credential | DPM
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Telephone | 561-799-9581
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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 | PO2994
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License Number State | FL
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