Provider Demographics
NPI:1710593975
Name:DR MICHAEL D PAULA DPM LLC
Entity Type:Organization
Organization Name:DR MICHAEL D PAULA DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAULA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-892-7959
Mailing Address - Street 1:16400 SW 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3816
Mailing Address - Country:US
Mailing Address - Phone:305-892-7959
Mailing Address - Fax:305-892-7960
Practice Address - Street 1:888 NE 126TH ST STE 200
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4964
Practice Address - Country:US
Practice Address - Phone:305-892-7959
Practice Address - Fax:305-892-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty