Provider Demographics
NPI:1548251051
Name:FELDMAN, RONALD (DPM)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 CORAL WAY
Mailing Address - Street 2:STE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1758
Mailing Address - Country:US
Mailing Address - Phone:305-668-9099
Mailing Address - Fax:305-668-9196
Practice Address - Street 1:6850 CORAL WAY
Practice Address - Street 2:STE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1758
Practice Address - Country:US
Practice Address - Phone:305-668-9099
Practice Address - Fax:305-668-9196
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00000555213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040992800Medicaid
FL1080010001Medicare NSC
87599Medicare ID - Type Unspecified
FL040992800Medicaid