Decubellis, Phillip D

Decubellis, Phillip D is an sole proprietor health care provider with primary practice located at 2828 E Commercial Blvd , Ft Lauderdale FL 33308-4206. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Decubellis, Phillip D can be contacted via phone (954) 776-5700.

Contact Information

Primary practice address
2828 E Commercial Blvd Ft Lauderdale FL 33308-4206
Phone: (954) 776-5700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO1934 Florida

Profile Details

NPI number 1568451813
LBN Legal business name Decubellis, Phillip D
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2005
Last updated Dec 3rd, 2013 - about 12 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 1568451813 NPPES
Florida MEDICAID 052057800

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