Organization
V MIROSHNICHENKO DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR MIROSHNICHENKO D.P.M. (PRESIDENT / OWNER)
(954) 721-1990
Entity
Organization
Contact information
Practice address
8333 W MCNAB RD, SUITE 116, TAMARAC, FL 33321-3242
(954) 721-1990
(954) 721-1932
Mailing address
8333 W MCNAB RD, SUITE 116, TAMARAC, FL 33321-3242
(954) 721-1990
(954) 721-1932
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2442
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP148
MEDICARE PTAN
FL
Enumeration date
08/07/2007
Last updated
04/26/2010
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