Provider Demographics
NPI:1659641850
Name:GREISSMAN, RONNIE (DPM)
Entity Type:Individual
Prefix:
First Name:RONNIE
Middle Name:
Last Name:GREISSMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 S OCEAN BLVD
Mailing Address - Street 2:APT 402
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3401
Mailing Address - Country:US
Mailing Address - Phone:561-733-4010
Mailing Address - Fax:
Practice Address - Street 1:7410 W BOYNTON BEACH BLVD
Practice Address - Street 2:B-6
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6156
Practice Address - Country:US
Practice Address - Phone:561-733-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-0002439213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist