PHILLIP D.DECUBELLIS PA NPI 1730239575

NPI Information

NPI: 1730239575
Provider Name: PHILLIP D.DECUBELLIS PA
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
2828 E COMMERCIAL BLVD
FORT LAUDERDALE, FL
ZIP 33308
Phone: (954) 776-5700
Get Directions

PHILLIP D.DECUBELLIS PA is a foot and ankle surgery podiatrist in Fort Lauderdale, FL. PHILLIP D.DECUBELLIS PA NPI is 1730239575. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2828 E COMMERCIAL BLVD
FORT LAUDERDALE, FL
ZIP 33308-206
Phone: (954) 776-5700
Fax: (954) 776-5701

The provider's authorized official is Phillip D Decubellis .
The authorized official title is Podiatric and has the following contact phone number (954) 776-5700.

The enumeration date for this NPI number is 1/12/2007 and was last updated on 1/2/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	K1117	OTHER	FLORIDA	PTAN
2	4291020001	MEDICARE NSC	FLORIDA
3	390494600	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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