Organization
PODIATRY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAMIDELE O OLUPONA DPM (CEO)
(202) 321-8812
Entity
Organization
Contact information
Practice address
2400 SW 69TH AVENUE, SUITE 140, MIAMI, FL 33155
(305) 450-1757
(305) 265-4844
Mailing address
2400 SW 69TH AVENUE, SUITE 140, MIAMI, FL 33155
(305) 450-1757
(305) 265-4844
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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