MEDICARE: DR. MICHAEL J BALL D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO1654	FL

General Provider Information

NPI Number	:	1205905247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J BALL D.P.M.

Provider Business Mailing Address
First Line	:	9080 KIMBERLY BLVD
Second Line	:	SUITE 7
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2862
Country	:	US
Telephone Number	:	561-483-4448
Fax Number	:	561-483-2167

Provider Business Practice Location Address
First Line	:	9080 KIMBERLY BLVD
Second Line	:	SUITE 7
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2862
Country	:	US
Telephone Number	:	561-483-4448
Fax Number	:	561-483-2167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	08/30/2010

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