| Organization Name: | BROWARD PODIATRY ASSOCIATES, PA |
| NPI Number: | 1003133489 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE F. JACOBSON (PRESIDENT/OWNER) |
| Mailing Address: | 3816 Hollywood Blvd Suite 206 Hollywood |
| State: | FL US |
| Postal Code: | 330216750 |
| Phone Number: | 9549870550 |
| Fax Number: | 9549870553 |
| NPI Enumeration Date: | 04/26/2010 |
| NPI Last Update Date: | 04/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | PO1504 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |