Provider Demographics
NPI:1245383470
Name:FARKAS WEISSBERG, LORRAINE R (DPM)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:R
Last Name:FARKAS WEISSBERG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8602 TOURMALINE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2420
Mailing Address - Country:US
Mailing Address - Phone:561-733-1762
Mailing Address - Fax:
Practice Address - Street 1:2825 N STATE ROAD 7
Practice Address - Street 2:SUITE 203
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-974-3311
Practice Address - Fax:954-974-0115
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2281213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65354OtherBCBS
FL236664OtherAVMED
FL480023457OtherRAILROAD MEDICARE
FL6200707OtherGHI
FL390236600Medicaid
FL236664OtherAVMED
FL65354OtherBCBS