| Organization Name: | BEVERLY HILLS FOOT AND ANKLE, P.A. |
| NPI Number: | 1003221706 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NISHA BALA KRISHNAN (PRESIDENT) |
| Mailing Address: | 3404 N Lecanto Hwy Suite A Beverly Hills |
| State: | FL US |
| Postal Code: | 344653569 |
| Phone Number: | 3525134867 |
| Fax Number: | 8883149873 |
| NPI Enumeration Date: | 06/23/2014 |
| NPI Last Update Date: | 12/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | PO3609 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |