Eric J Lullove DPM PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3133 Issued in FL

Legal business name

ERIC J LULLOVE DPM PA

Practice address

4855 W Hillsboro Blvd Ste B6
Coconut Creek, FL 33073-4356

Phone

(561) 989-9780

Fax

(561) 989-9781

NPI assigned

Mar 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eric Jay Lullove, D.P.M.NPI 1104811744

Title

Owner/President

Phone

(561) 989-9780

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Jay Lullove, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Coconut Creek, FL
  • NPI 1104811744
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1952361891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W HILLSBORO BLVD STE B6",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734356",
            "telephone_number": "561-989-9780",
            "fax_number": "561-989-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W HILLSBORO BLVD STE B6",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734356",
            "telephone_number": "561-989-9780",
            "fax_number": "561-989-9781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 W Palmetto Park Rd",
            "address_2": "Suite 201-C",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334333458",
            "country_code": "US",
            "telephone_number": "561-989-9780",
            "fax_number": "561-989-9781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ERIC J LULLOVE DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "LULLOVE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "561-989-9780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3133",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PO3133",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340480300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Coconut Creek, FL
• Providers in Coconut Creek, 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 Apr 13, 2020; 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.