Provider Demographics
NPI:1750498424
Name:REED, RALPH W (DPM)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:W
Last Name:REED
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:575 AVENUE K SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4215
Mailing Address - Country:US
Mailing Address - Phone:863-293-1950
Mailing Address - Fax:293-293-1899
Practice Address - Street 1:575 AVENUE K SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4215
Practice Address - Country:US
Practice Address - Phone:863-293-1950
Practice Address - Fax:863-293-1899
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO675213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480028215OtherRAILROAD MEDICARE
FL87292OtherBC BS FL
FL1318640001OtherDME PALMETTO
FL1750498424OtherINDIV NPI
FL1043321763OtherGROUP NPI
FLK0339OtherMEDICARE GROUP #
FLT55402Medicare UPIN
FL480028215OtherRAILROAD MEDICARE