Provider Demographics
NPI:1093999690
Name:CAREN L BLOCK DPM PA
Entity Type:Organization
Organization Name:CAREN L BLOCK DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM PA
Authorized Official - Phone:561-640-3838
Mailing Address - Street 1:6901 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE C-11
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2511
Mailing Address - Country:US
Mailing Address - Phone:561-604-3838
Mailing Address - Fax:561-478-5259
Practice Address - Street 1:6901 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE C-11
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2511
Practice Address - Country:US
Practice Address - Phone:561-604-3838
Practice Address - Fax:561-478-5259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1754332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87985Medicare PIN
FL4218840001Medicare NSC
FLT55635Medicare UPIN