Organization
SOUTH FLORIDA PODIATRIC ASSOCIATES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD BRUCE PETUSEVSKY DPM (PRESIDENT)
(954) 742-4343
Entity
Organization
Contact information
Practice address
7769 NW 44TH ST., SUNRISE, FL 33351-6203
(954) 742-4343
(954) 572-8335
Mailing address
7769 NW 44TH ST, SUNRISE, FL 33351-6203
(954) 742-4343
(954) 572-8335
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO1813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87950
PODIATRY
FL
Enumeration date
11/21/2006
Last updated
03/20/2012
Update your record
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