Provider Demographics
NPI:1174549216
Name:JAFFE, STEVEN D (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:JAFFE
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 1:1325 S CONGRESS AVE
Mailing Address - Street 2:#108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5802
Mailing Address - Country:US
Mailing Address - Phone:561-734-3960
Mailing Address - Fax:561-734-2811
Practice Address - Street 1:1325 S CONGRESS AVE
Practice Address - Street 2:#108
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5802
Practice Address - Country:US
Practice Address - Phone:561-734-3960
Practice Address - Fax:561-734-2811
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL213ES0103X213ES0103X
FLP01445213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55537Medicare UPIN
FL4990430001Medicare NSC
FL87765Medicare PIN