Provider Demographics
NPI:1598115636
Name:TAUB, JESSICA E (DPM)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:E
Last Name:TAUB
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:BINKOFSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:3515 SE WILLOUGHBY BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5059
Mailing Address - Country:US
Mailing Address - Phone:772-283-3800
Mailing Address - Fax:772-283-7046
Practice Address - Street 1:3515 SE WILLOUGHBY BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5059
Practice Address - Country:US
Practice Address - Phone:772-283-3800
Practice Address - Fax:772-283-7046
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4065213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO4065OtherFL MEDICAL LICENSE (DPM)
14396065OtherCAQH ID
FLFT8242961OtherDEA