Provider Demographics
NPI:1669469102
Name:PODIATRY INTERNATIONAL, INC.
Entity Type:Organization
Organization Name:PODIATRY INTERNATIONAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KALOIAN
Authorized Official - Middle Name:GEORGIEV
Authorized Official - Last Name:OUZOUNOV
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-803-6755
Mailing Address - Street 1:3051 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1257
Mailing Address - Country:US
Mailing Address - Phone:305-803-6755
Mailing Address - Fax:305-642-5213
Practice Address - Street 1:3051 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1257
Practice Address - Country:US
Practice Address - Phone:305-803-6755
Practice Address - Fax:305-642-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2889213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3559Medicare ID - Type UnspecifiedPROVIDER #