Provider Demographics
NPI:1154663235
Name:PURTUC, RADU DAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:RADU
Middle Name:DAN
Last Name:PURTUC
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 1:1285 36TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6588
Mailing Address - Country:US
Mailing Address - Phone:772-567-0111
Mailing Address - Fax:772-257-6521
Practice Address - Street 1:1285 36TH ST STE 203
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6588
Practice Address - Country:US
Practice Address - Phone:772-567-0111
Practice Address - Fax:772-257-6521
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4273213EP1101X, 213ES0103X
MI5901002490213ES0103X, 213EP1101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program