Provider Demographics
NPI:1013478924
Name:SY, EDGAR FRANCIS EUSOOF (DPM)
Entity Type:Individual
Prefix:
First Name:EDGAR FRANCIS
Middle Name:EUSOOF
Last Name:SY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:EDGAR FRANCIS
Other - Middle Name:EUSOOF
Other - Last Name:SY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10041 PINES BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6170
Mailing Address - Country:US
Mailing Address - Phone:142-696-5767
Mailing Address - Fax:
Practice Address - Street 1:10041 PINES BLVD STE E
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6170
Practice Address - Country:US
Practice Address - Phone:954-437-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005967213ES0103X
FLPO4478213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery