Provider Demographics
NPI:1245217876
Name:FINKE, BRIAN DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DAVID
Last Name:FINKE
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 1:7144 N NOB HILL RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1839
Mailing Address - Country:US
Mailing Address - Phone:954-720-5922
Mailing Address - Fax:954-722-5062
Practice Address - Street 1:7144 N NOB HILL RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1839
Practice Address - Country:US
Practice Address - Phone:954-720-5922
Practice Address - Fax:954-722-5062
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-24
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1234213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87645BMedicare ID - Type Unspecified
FL87645CMedicare PIN
FL1325400001Medicare NSC