Provider Demographics
NPI:1568536902
Name:BOCA RATON PODIATRY, PA
Entity Type:Organization
Organization Name:BOCA RATON PODIATRY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FRISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-395-4243
Mailing Address - Street 1:950 GLADES RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6401
Mailing Address - Country:US
Mailing Address - Phone:561-395-4243
Mailing Address - Fax:561-392-8353
Practice Address - Street 1:950 GLADES RD STE 2A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6401
Practice Address - Country:US
Practice Address - Phone:561-395-4243
Practice Address - Fax:561-392-8353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001527213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT95181Medicare PIN
FL0551080001Medicare NSC
FL39234Medicare ID - Type UnspecifiedMEDICARE PROVIDER #