Provider Demographics
NPI:1104090810
Name:PODICARE INC
Entity type:Organization
Organization Name:PODICARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GALITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD DPM
Authorized Official - Phone:954-923-7440
Mailing Address - Street 1:3440 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6927
Mailing Address - Country:US
Mailing Address - Phone:954-923-7440
Mailing Address - Fax:954-241-5191
Practice Address - Street 1:3440 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 460
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6927
Practice Address - Country:US
Practice Address - Phone:954-923-7440
Practice Address - Fax:954-241-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID