Provider Demographics
NPI:1861679540
Name:ALLEN J TAURITZ DPM PA
Entity Type:Organization
Organization Name:ALLEN J TAURITZ DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAURITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-498-7200
Mailing Address - Street 1:15300 JOG RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2162
Mailing Address - Country:US
Mailing Address - Phone:561-492-7200
Mailing Address - Fax:561-498-9068
Practice Address - Street 1:15300 JOG RD
Practice Address - Street 2:SUITE 110
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2162
Practice Address - Country:US
Practice Address - Phone:561-492-7200
Practice Address - Fax:561-498-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 887213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55449Medicare UPIN
FL4146110001Medicare NSC
FL87571Medicare PIN