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 (OWNER)
(561) 995-0229
Entity
Organization
Contact information
Practice address
1601 CLINT MOORE RD STE 180, BOCA RATON, FL 33487-5713
(561) 995-0229
(561) 989-0775
Mailing address
1601 CLINT MOORE RD STE 180, BOCA RATON, FL 33487-5713
(561) 369-2199
(561) 935-1582
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3007
FL
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005L
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
05
—
001593100
—
FL
01
—
10D2092005
CLIA
FL
01
—
CA001A
MEDICARE
FL
Enumeration date
07/06/2009
Last updated
10/09/2024
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