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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KALI ETHEREDGE, DPM

Active Sole Proprietor

DR. KALI ETHEREDGE, DPM is a Podiatrist healthcare provider located in LAKE PARK, Florida. NPI 1063429702 is currently active in the NPPES registry. Verify at CMS.

Podiatrist · LAKE PARK, FL

Registration Details

NPI Number
1063429702
Provider Type
Individual
Gender
Female
NPI Issued
Aug 2, 2006 (20.07395653745 yrs)
Last Updated
Mar 7, 2023
Licenses
POD001044 (GA)
PO3255 (FL)
Sole Proprietor
Yes

Practice Information

Address
701 PARK AVE
LAKE PARK, FL, 334032503
Browse FL providers · Browse ZIP 33403
Phone
5618487722
Fax
5618487812
Primary Specialty
Podiatrist
213E00000X
Additional Specialty
Podiatrist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.