Etheredge, Kali

Etheredge, Kali is an sole proprietor health care provider with primary practice located at 701 Park Ave , Lake Park FL 33403-2503. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Etheredge, Kali can be contacted via phone (561) 848-7722.

Contact Information

Primary practice address
701 Park Ave Lake Park FL 33403-2503
Phone: (561) 848-7722
Fax: (561) 848-7812
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD001044 Georgia
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO3255 Florida

Profile Details

NPI number 1063429702
LBN Legal business name Etheredge, Kali
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063429702 NPPES
Florida Other PO3255 STATE LICENSE
Florida Other POD001044 STATE LICENSE

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