MEDICARE: JOSEPH N. URICCHIO, DPM PA

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	213EP1101X	Primary Podiatric Medicine Podiatrist	PO0001641	FL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO0001641	FL
3	213ES0131X	Foot Surgery Podiatrist	PO0001641	FL
4	213E00000X	Podiatrist	PO0001641	FL

General Provider Information

NPI Number	:	1710150602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH N. URICCHIO, DPM PA

Provider Business Mailing Address
First Line	:	5602 PGA BLVD
Second Line	:	SUITE 101
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3829
Country	:	US
Telephone Number	:	561-627-6444
Fax Number	:	561-627-3572

Provider Business Practice Location Address
First Line	:	5602 PGA BLVD
Second Line	:	STE 101
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3829
Country	:	US
Telephone Number	:	561-627-6444
Fax Number	:	561-627-3572

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. JOSEPH N. URICCHIO
Credential	:	DPM, PA
Telephone Number	:	561-627-6444

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	01/25/2012

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