Provider Demographics
NPI:1942483987
Name:FARKAS ENTERPRISES FOOT & ANKLE SPORTS MEDICINE
Entity Type:Organization
Organization Name:FARKAS ENTERPRISES FOOT & ANKLE SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:MARINAU
Authorized Official - Last Name:FARKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-454-6743
Mailing Address - Street 1:1001 N FEDERAL HWY
Mailing Address - Street 2:SUITE101
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2400
Mailing Address - Country:US
Mailing Address - Phone:954-454-6743
Mailing Address - Fax:954-454-6836
Practice Address - Street 1:1001 N FEDERAL HWY
Practice Address - Street 2:SUITE101
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2400
Practice Address - Country:US
Practice Address - Phone:954-454-6743
Practice Address - Fax:954-454-6836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2957213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4550910001Medicare NSC
FLU88972Medicare UPIN