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:
Health care specialties
| Specialty | Code | License # | 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 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063429702 | NPPES |
| Florida | Other | PO3255 | STATE LICENSE |
| Florida | Other | POD001044 | STATE LICENSE |
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