Provider Demographics
NPI:1710150602
Name:JOSEPH N. URICCHIO, DPM PA
Entity Type:Organization
Organization Name:JOSEPH N. URICCHIO, DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:URICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, PA
Authorized Official - Phone:561-627-6444
Mailing Address - Street 1:5602 PGA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3829
Mailing Address - Country:US
Mailing Address - Phone:561-627-6444
Mailing Address - Fax:561-627-3572
Practice Address - Street 1:5602 PGA BLVD
Practice Address - Street 2:STE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3829
Practice Address - Country:US
Practice Address - Phone:561-627-6444
Practice Address - Fax:561-627-3572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001641213E00000X, 213EP1101X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4212400001Medicare NSC