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PHILLIP D DECUBELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2828 E COMMERCIAL BLVD, FT LAUDERDALE, FL 33308-4206
(954) 776-5700
Mailing address
2828 E COMMERCIAL BLVD, FT LAUDERDALE, FL 33308-4206
(954) 776-5700

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO1934
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
052057800
FL
Enumeration date
10/19/2005
Last updated
12/03/2013
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