Provider Demographics
NPI:1205905247
Name:BALL, MICHAEL J (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:BALL
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:9080 KIMBERLY BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2862
Mailing Address - Country:US
Mailing Address - Phone:561-483-4448
Mailing Address - Fax:561-483-2167
Practice Address - Street 1:9080 KIMBERLY BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2862
Practice Address - Country:US
Practice Address - Phone:561-483-4448
Practice Address - Fax:561-483-2167
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2010-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPO1654213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0470150001Medicare NSC