Metzendorf, David Ira

Metzendorf, David Ira is an individual health care provider with primary practice located at 135 1St St South , Winter Haven FL 33880. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Metzendorf, David Ira can be contacted via phone (863) 293-1968.

Contact Information

Primary practice address
135 1St St South Winter Haven FL 33880
Phone: (863) 293-1968
Fax: (863) 293-7961
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO0001385 Florida

Profile Details

NPI number 1689680621
LBN Legal business name Metzendorf, David Ira
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Dec 23rd, 2010 - about 16 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 1689680621 NPPES
Florida MEDICAID 029684800
Florida Other 593258147

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