Tyson Tabora DPM PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3687 Issued in FL

Legal business name

TYSON TABORA DPM PA

Doing business as

The Foot and Ankle Clinic

Practice address

12989 Southern Blvd Ste 205
Loxahatchee, FL 33470-9291

Phone

(561) 809-2343

Fax

(888) 491-0775

NPI assigned

Mar 5, 2018

Last updated

Aug 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyson Joseph Tabora, DPMNPI 1881087443

Title

Owner/Physician

Phone

(561) 809-2343

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Foot and Ankle Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyson Joseph Tabora, DPM

  • Podiatrist
  • Loxahatchee, FL
  • NPI 1881087443
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1568964633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12989 SOUTHERN BLVD STE 205",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709291",
            "telephone_number": "561-809-2343",
            "fax_number": "888-491-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12989 SOUTHERN BLVD STE 205",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709291",
            "telephone_number": "561-809-2343",
            "fax_number": "888-491-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSON TABORA DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "TABORA",
        "authorized_official_first_name": "TYSON",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "561-809-2343",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115978600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Foot and Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlene Torres, IBCLC
• Melissa Marie Totman
• Jenny N Tran, MD
• Transitional Care Medical Associates Inc.
• Ana Luisa Tupac-Yupanqui Safra, M.D.
• Abegail R Unico, APRN
• United Health Services, LLC.
• Urology Center of Palm Beach P a
• Valerie Marie Vadenais
• Raul Carlos Valdescruz, MD

• Foot & Ankle Surgery Podiatrist in Loxahatchee, FL
• Providers in Loxahatchee, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.