Provider Demographics
NPI:1467947796
Name:PALM BEACH PODIATRY, P.A.
Entity Type:Organization
Organization Name:PALM BEACH PODIATRY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-840-0491
Mailing Address - Street 1:2051 45TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2029
Mailing Address - Country:US
Mailing Address - Phone:561-840-0491
Mailing Address - Fax:
Practice Address - Street 1:2051 45TH ST STE 201
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2029
Practice Address - Country:US
Practice Address - Phone:561-840-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3956213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty