South Florida Podiatric Associates P a

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

PO1813 Issued in FL

Legal business name

SOUTH FLORIDA PODIATRIC ASSOCIATES P A

Practice address

7769 NW 44TH St.
Sunrise, FL 33351-6203

Phone

(954) 742-4343

Fax

(954) 572-8335

NPI assigned

Nov 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Howard Bruce Petusevsky, DPM

Title

President

Phone

(954) 742-4343

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1326113861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7769 NW 44TH ST",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516203",
            "telephone_number": "954-742-4343",
            "fax_number": "954-572-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7769 NW 44TH ST.",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516203",
            "telephone_number": "954-742-4343",
            "fax_number": "954-572-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA PODIATRIC ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "PETUSEVSKY",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-742-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO1813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRY",
            "identifier": "87950",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Florida Community Care Network, LLC (Community Care Plan)
• South Florida Endodontics
• South Florida Medical Centers Inc (Amicus Medical Center)
• South Florida Pain & Rehabilitation of West Broward
• South Florida Physical Therapy Associates Inc.
• South Florida Primary Healthcare
• South Florida Surgical Specialists, LLC
• South Miami Hospital, Inc (Baptist Health Urgent Care at Sawgrass)
• Southern Cardio LLC
• Southern RX LLC (Bellevue Pharmacy)

• Primary Podiatric Medicine Podiatrist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Primary Podiatric Medicine Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.