Provider Demographics
NPI:1407071475
Name:BESS, MICHAEL STEVEN (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEVEN
Last Name:BESS
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 1:1001 SW 141ST AVE APT 210
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1567
Mailing Address - Country:US
Mailing Address - Phone:561-689-0303
Mailing Address - Fax:561-684-8884
Practice Address - Street 1:1001 SW 141ST AVE APT 210
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1567
Practice Address - Country:US
Practice Address - Phone:561-689-0303
Practice Address - Fax:561-684-8884
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2639213E00000X
FLPO-2639213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390365600Medicaid
FL65531Medicare ID - Type Unspecified