Provider Demographics
NPI:1073591863
Name:HAIMON, CORY BRUCE (DPM)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:BRUCE
Last Name:HAIMON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7431 W ATLANTIC AVE STE 33
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3505
Mailing Address - Country:US
Mailing Address - Phone:561-496-6900
Mailing Address - Fax:561-496-5348
Practice Address - Street 1:7431 W ATLANTIC AVE STE 33
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3505
Practice Address - Country:US
Practice Address - Phone:561-496-6900
Practice Address - Fax:561-496-5348
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00001592213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029646500Medicaid
FL4623420001Medicare NSC
FL029646500Medicaid
FL87909YMedicare PIN
FL72837Medicare PIN