Podiatry Center PA

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

PODIATRY CENTER PA

Practice address

408 S 1St St
Lake Wales, FL 33853-4146

Phone

(863) 676-1710

Fax

(863) 676-0025

NPI assigned

Jan 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. David Ira Metzendorf, DPM

Title

Pres

Phone

(863) 293-1968

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1437336542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S 1ST ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534146",
            "telephone_number": "863-676-1710",
            "fax_number": "863-676-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S 1ST ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534146",
            "telephone_number": "863-676-1710",
            "fax_number": "863-676-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "METZENDORF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "863-293-1968",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.