Provider Demographics
NPI:1205227147
Name:LYLE SKLAR
Entity Type:Organization
Organization Name:LYLE SKLAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-736-1033
Mailing Address - Street 1:112 S FEDERAL HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4939
Mailing Address - Country:US
Mailing Address - Phone:561-736-1033
Mailing Address - Fax:
Practice Address - Street 1:112 S FEDERAL HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-4939
Practice Address - Country:US
Practice Address - Phone:561-736-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBS5218284213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013923853Medicaid
FL1013923853Medicare UPIN
FL1013923853Medicare PIN
FL1013923853Medicaid
FL1013923853Medicare NSC