Provider Demographics
NPI:1710996905
Name:SAPENOFF & HARRIS PA
Entity Type:Organization
Organization Name:SAPENOFF & HARRIS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPENOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-689-1414
Mailing Address - Street 1:4678 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-4624
Mailing Address - Country:US
Mailing Address - Phone:561-689-1414
Mailing Address - Fax:561-689-1993
Practice Address - Street 1:4678 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4624
Practice Address - Country:US
Practice Address - Phone:561-689-1414
Practice Address - Fax:561-689-1993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0566260001Medicare NSC
FL77116Medicare PIN