Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Podiatric Medicine |
213EP1101X | 48 | Podiatry | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1699802090 |
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| LBN Legal business name | FAMILY FOOTCARE, PC | ||||||||
| Authorized official | JAMES DEJESUS - (PODIATRIST) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 02/27/2007 | ||||||||
| Last updated | 09/14/2022 - About 4 years ago | ||||||||
| Identifiers |
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