Provider Demographics
NPI:1982055000
Name:HEART AND SOLE PODIATRY ASSOCIATES LLC
Entity Type:Organization
Organization Name:HEART AND SOLE PODIATRY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:DR
Authorized Official - First Name:JODEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, MS
Authorized Official - Phone:786-333-5284
Mailing Address - Street 1:3800 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6706
Mailing Address - Country:US
Mailing Address - Phone:305-681-2600
Mailing Address - Fax:305-685-5098
Practice Address - Street 1:3800 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7793
Practice Address - Country:US
Practice Address - Phone:305-681-2600
Practice Address - Fax:305-685-5098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty