Organization
PHILLIP D.DECUBELLIS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP D DECUBELLIS DPM (PODIATRIC)
(954) 776-5700
Entity
Organization
Contact information
Practice address
2828 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-4206
(954) 776-5700
(954) 776-5701
Mailing address
2828 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-4206
(954) 776-5700
(954) 776-5701
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390494600
—
FL
01
—
K1117
PTAN
FL
Enumeration date
01/12/2007
Last updated
01/02/2014
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