Provider Demographics
NPI:1518546449
Name:UPSCALE FOOT LLC
Entity Type:Organization
Organization Name:UPSCALE FOOT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASISTENTE ADMINISTRATIVO
Authorized Official - Prefix:
Authorized Official - First Name:DYMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-399-3755
Mailing Address - Street 1:PO BOX 8028
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8028
Mailing Address - Country:US
Mailing Address - Phone:813-753-6382
Mailing Address - Fax:
Practice Address - Street 1:URB. VALLE VERDE
Practice Address - Street 2:PASEO REAL 1014 SUITE 1
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0072
Practice Address - Country:US
Practice Address - Phone:787-501-5941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty