Provider Demographics
NPI:1255599932
Name:FOSTER, KEITH JEFFREY (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:JEFFREY
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:3600 WASHINGTON ST
Practice Address - Street 2:SUITE 2005
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8216
Practice Address - Country:US
Practice Address - Phone:954-518-2424
Practice Address - Fax:954-981-3476
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2017-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME-112738208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation