| Dr Kali Etheredge, DPM | |
|
701 Park Ave, Lake Park, FL 33403-2503 | |
| (561) 848-7722 | |
| (561) 848-7812 |
| Full Name | Dr Kali Etheredge |
|---|---|
| Gender | Female |
| Speciality | Podiatry |
| Experience | 21 Years |
| Location | 701 Park Ave, Lake Park, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063429702 | NPI | - | NPPES |
| PO3255 | Other | FL | STATE LICENSE |
| POD001044 | Other | GA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | POD001044 (Georgia) | Secondary |
| 213E00000X | Podiatrist | PO3255 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Mary's Medical Center | West palm beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Palm Beach Foot And Ankle Inc | 1456379056 | 8 |
| Provider Name | Palm Beach Foot & Ankle Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1316035454 PECOS PAC ID: 1456379056 Enrollment ID: O20051102000629 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kali Etheredge, DPM 11380 Prosperity Farms Rd Ste 221e, Palm Beach Gardens, FL 33410-3465 Ph: (561) 848-7722 | Dr Kali Etheredge, DPM 701 Park Ave, Lake Park, FL 33403-2503 Ph: (561) 848-7722 |
Dr. Henry Kay Stark, D.P.M. Podiatrist Medicare: Medicare Enrolled Practice Location: 701 Park Ave, Lake Park, FL 33403 Phone: 561-284-6886 Fax: 561-627-2199 | |
Mobile Wound Care Associates, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 701 Park Ave, Lake Park, FL 33403 Phone: 561-848-7722 | |
Lake Park Podiatry Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 701 Park Ave, Lake Park, FL 33403 Phone: 561-294-6886 Fax: 561-627-2199 |