Provider Demographics
NPI:1285618272
Name:MERENDINO, JOSEPH (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:MERENDINO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22023 STATE ROAD 7
Mailing Address - Street 2:SUITE #101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-3401
Mailing Address - Country:US
Mailing Address - Phone:561-353-3333
Mailing Address - Fax:
Practice Address - Street 1:22023 STATE ROAD 7
Practice Address - Street 2:SUITE #101
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-3401
Practice Address - Country:US
Practice Address - Phone:561-353-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2534213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00699369OtherRAILROAD MEDICARE
FLU59336Medicare UPIN
FLP00699369OtherRAILROAD MEDICARE