Provider Demographics
NPI:1104882489
Name:URICCHIO, JOSEPH NICHOLAS (DPM)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:NICHOLAS
Last Name:URICCHIO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 PGA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3829
Mailing Address - Country:US
Mailing Address - Phone:561-627-6444
Mailing Address - Fax:561-627-3572
Practice Address - Street 1:5602 PGA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3829
Practice Address - Country:US
Practice Address - Phone:561-627-6444
Practice Address - Fax:561-627-3572
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001641213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO00000983OtherRAILROAD MEDICARE
FLPO00000983OtherRAILROAD MEDICARE
FLEW714AMedicare PIN
FL87870Medicare ID - Type Unspecified