Provider Demographics
NPI:1205853009
Name:PALM BEACH FAMILY FOOT CARE, P.A.
Entity type:Organization
Organization Name:PALM BEACH FAMILY FOOT CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FRENCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-498-9066
Mailing Address - Street 1:15300 JOG ROAD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2164
Mailing Address - Country:US
Mailing Address - Phone:561-498-9066
Mailing Address - Fax:561-498-9068
Practice Address - Street 1:15300 JOG ROAD
Practice Address - Street 2:SUITE #110
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2164
Practice Address - Country:US
Practice Address - Phone:561-498-9066
Practice Address - Fax:561-498-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP02926213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340213400Medicaid
FLK3742Medicare PIN
FLU85394Medicare UPIN
FL5324080001Medicare NSC