Organization Name: | IMPERIAL POINT PODIATRY ASSOC INC |
NPI Number: | 1013038272 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERENCE D MCDONALD (OWNER) |
Mailing Address: | 6405 N Federal Hwy Suite 405 Fort Lauderdale |
State: | FL US |
Postal Code: | 333081412 |
Phone Number: | 9547715900 |
Fax Number: | 9547715959 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 02/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |