# PODOCARE CLINICAL SPECIALIST PROFESSIONAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962098434
- **Authorized official:** GREGORIO CABAN DPM (PRESIDENT ADMIN)
- **Authorized official phone:** (305) 396-8731

## Contact information

- **Practice address:** 2000 NW 87TH AVE STE 217, DORAL, FL 33172-2657
- **Practice address phone:** (305) 396-8731
- **Practice address fax:** (305) 396-8732
- **Mailing address:** 2000 NW 87TH AVE STE 217, DORAL, FL 33172-2657
- **Mailing address phone:** (305) 396-8731
- **Mailing address fax:** (305) 396-8732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/17/2020
- **Last updated:** 12/17/2020