| NPI | 1952361891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC JAY LULLOVE Owner/President 561-989-9780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3133) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PO3133) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-04-13 |