Organization
ERIC J LULLOVE DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC JAY LULLOVE D.P.M. (OWNER/PRESIDENT)
(561) 989-9780
Entity
Organization
Contact information
Practice address
4855 W HILLSBORO BLVD STE B6, COCONUT CREEK, FL 33073-4356
(561) 989-9780
(561) 989-9781
Mailing address
4855 W HILLSBORO BLVD STE B6, COCONUT CREEK, FL 33073-4356
(561) 989-9780
(561) 989-9781
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3133
FL
332B00000X
Durable Medical Equipment & Medical Supplies
PO3133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340480300
—
FL
Enumeration date
03/24/2006
Last updated
04/13/2020
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