Basic Information
| Provider Information | |||||||||
| NPI: | 1043406887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINKEL | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 712 THE RIALTO | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342853524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9414880222 | ||||||||
| FaxNumber: | 9414801668 | ||||||||
| Practice Location | |||||||||
| Address1: | 712 THE RIALTO | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342853524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9414880222 | ||||||||
| FaxNumber: | 9414801668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2007 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0131X | PO-1580 | FL | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
ID Information
| ID | Type | State | Issuer | Description | DQ5231 | 01 | FL | RAILROAD MEDICARE GROUP PTAN | OTHER | P00849586 | 01 | FL | RAILROAD MEDICARE PROV PTAN | OTHER | 041248100 | 05 | FL | MEDICAID | 1307950001 | 01 | DME | OTHER | 74640 | 01 | FL | BLUE CROSS BLUE SHIELD GRP# | OTHER |