Provider Demographics
NPI:1265583611
Name:FOOT SOLUTIONS BOYNTON BEACH
Entity type:Organization
Organization Name:FOOT SOLUTIONS BOYNTON BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPPERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-738-7800
Mailing Address - Street 1:7410 BOYNTON BEACH BLVD STE A-9
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6156
Mailing Address - Country:US
Mailing Address - Phone:561-738-7800
Mailing Address - Fax:561-732-1801
Practice Address - Street 1:7410 BOYNTON BEACH BLVD STE A-9
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6156
Practice Address - Country:US
Practice Address - Phone:561-738-7800
Practice Address - Fax:561-732-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
G7529OtherEMPIRE BC
FL99998OtherBCBS
FL99998OtherBCBS
G7529OtherEMPIRE BC