Provider Demographics
NPI:1083670947
Name:PARTRIDGE, CARMEN O (DPM)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:O
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:O
Other - Last Name:LUCIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:1979 W HILLSBORO BLVD STE 1
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1444
Practice Address - Country:US
Practice Address - Phone:954-428-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-2600213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390330300Medicaid
FL390330300Medicaid
FL65486AMedicare PIN