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Organization
PODOCARE CLINICAL SPECIALIST PROFESSIONAL LLC
Active
Organization
PODOCARE CLINICAL SPECIALIST PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORIO CABAN DPM (PRESIDENT ADMIN)
(305) 396-8731
Entity
Organization
Contact information
Practice address
2000 NW 87TH AVE STE 217, DORAL, FL 33172-2657
(305) 396-8731
(305) 396-8732
Mailing address
2000 NW 87TH AVE STE 217, DORAL, FL 33172-2657
(305) 396-8731
(305) 396-8732
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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