Organization
CERTIFIED FOOT & ANKLE SPECIALISTS
Active
Organization
CERTIFIED FOOT & ANKLE SPECIALISTS
Active
Other names
Multi-Specialty Physician Services
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE J KINMON DPM (PRESIDENT)
(561) 995-0229
Entity
Organization
Contact information
Practice address
140 JUPITER LAKES BLVD STE A, JUPITER, FL 33458-7196
(561) 320-9298
(772) 288-3341
Mailing address
1601 CLINT MOORE RD STE 180, BOCA RATON, FL 33487-5713
(561) 995-0229
(561) 989-0775
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001593100
—
FL
Enumeration date
08/07/2019
Last updated
10/09/2024
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