Contract Details
Ancillary Care Services
Facility name
Podiatry Associates
Provider ID
P000005151
NPI
1700819620
Tax ID
591270737
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2651 Hollywood Boulevard
Hollywood, FL 33020
United States
County
Broward
Phone
9549231800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address