Provider Demographics
NPI:1215127402
Name:FOOT & ANKLE SPECIALISTS OF MIAMI BEACH, P.A.
Entity type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF MIAMI BEACH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-695-7777
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 710
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4558
Mailing Address - Country:US
Mailing Address - Phone:305-695-7777
Mailing Address - Fax:305-695-7707
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 710
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4558
Practice Address - Country:US
Practice Address - Phone:305-695-7777
Practice Address - Fax:305-695-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00289OtherMEDICARE GROUP
FL00289OtherMEDICARE GROUP