Provider Demographics
NPI:1801883103
Name:LAMPERT, ELLIOTT S (DPM)
Entity type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:S
Last Name:LAMPERT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:8200 NW 27 ST
Mailing Address - Street 2:STE 108
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1906
Mailing Address - Country:US
Mailing Address - Phone:786-662-3893
Mailing Address - Fax:786-662-3899
Practice Address - Street 1:1437 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2202
Practice Address - Country:US
Practice Address - Phone:305-642-0488
Practice Address - Fax:305-643-1540
Is Sole Proprietor?:No
Enumeration Date:2005-10-02
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO1135213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040953700Medicaid
FLT95156Medicare UPIN
FL040953700Medicaid