Provider Demographics
NPI:1427106285
Name:ALL FLORIDA FOOTCARE, INC.
Entity type:Organization
Organization Name:ALL FLORIDA FOOTCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-439-0500
Mailing Address - Street 1:5845 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1347
Mailing Address - Country:US
Mailing Address - Phone:561-439-0500
Mailing Address - Fax:561-439-6669
Practice Address - Street 1:5845 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1347
Practice Address - Country:US
Practice Address - Phone:561-439-0500
Practice Address - Fax:561-439-6669
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALL FLORIDA FOOTCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-08
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL213E00000X213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390398200Medicaid
FL21353Medicare ID - Type Unspecified