Provider Demographics
NPI:1295008290
Name:SOUTH FLORIDA FOOT & ANKLE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:SOUTH FLORIDA FOOT & ANKLE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERKOWTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-695-7777
Mailing Address - Street 1:4308 ALTON RD STE 710
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4557
Mailing Address - Country:US
Mailing Address - Phone:305-695-7777
Mailing Address - Fax:305-697-7707
Practice Address - Street 1:4308 ALTON RD STE 710
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4557
Practice Address - Country:US
Practice Address - Phone:305-695-7777
Practice Address - Fax:305-697-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2772213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002V6OtherBCBS
FL002V6OtherBCBS