Contract Details
Ancillary Care Services
Facility name
Family Podiatry Associates
Provider ID
P000005147
NPI
1700073327
Tax ID
650569491
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
17971 Biscayne Boulevard Suite 109
Aventura, FL 33160
United States
County
Miami-Dade
Phone
3059332666 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address