Provider Demographics
NPI:1992708341
Name:HOLTZMAN, BRUCE JAMES (DPM)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JAMES
Last Name:HOLTZMAN
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 1:6630 CONCH CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3651
Mailing Address - Country:US
Mailing Address - Phone:561-336-4369
Mailing Address - Fax:561-336-4370
Practice Address - Street 1:7060 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4650
Practice Address - Country:US
Practice Address - Phone:561-336-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000830213E00000X
FLPO1127213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029662700Medicaid
FL87728Medicare PIN
FL029662700Medicaid