Organization
CERTIFIED FOOT & ANKLE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE KINMON MD (OWNER)
(561) 336-1703
Entity
Organization
Contact information
Practice address
4879 COCONUT CREEK PKWY, COCONUT CREEK, FL 33063-3944
(954) 979-0505
(954) 979-4298
Mailing address
1601 CLINT MOORE RD, SUITE 130, BOCA RATON, FL 33487-2768
(561) 995-0229
(561) 989-0775
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3007
FL
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/28/2017
Last updated
10/09/2024
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