is a Foot & Ankle Surgery in , . practices all healthcare services and medical treatments related to Foot & Ankle Surgery. The NPI Number for is 1699886648. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1699886648 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Foot & Ankle Surgery |
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| Taxonomy | 213Es0103X |
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Definition: A doctor of podiatric medicine who diagnoses and treats disorders and injuries to the foot, ankle and related structures. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 229725 | FL | BEECH STREET | |
| 53192 | FL | HEALTHSUN | |
| MCS820 | FL | TRICARE | |
| 2926700 | FL | -- | |
| 10000500952 | FL | BEECH STREET | |
| 325538 | FL | UNITED HEALTHCARE | |
| 3679481 | FL | OXFORD | |
| 593483757 | FL | TRICARE | |
| 400000058000 | FL | PREFERRED CARE PARTNERS | |
| 6958200 | FL | JMH HEALTHCARE PLAN |
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