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NPI Code Detail

MEDICARE: DR. MICHAEL FRANCIS FEDERICO D.P.M.

MEDICARE: DR. MICHAEL FRANCIS FEDERICO D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist0104NV

General Provider Information

NPI Number : 1023066842
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL FRANCIS FEDERICO D.P.M.
Provider Business Mailing Address
First Line : 8835 HICKAM AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-3626
Country : US
Telephone Number : 702-657-9228
Fax Number : 702-657-9586
Provider Business Practice Location Address
First Line : 4001 N. LAS VEGAS BLVD.
Second Line : MOFH NELLIS AFB 3C
City : N. LAS VEGAS
State : NV
Zip : 89191
Country : US
Telephone Number : 702-653-3134
Fax Number : 702-653-2790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/08/2007

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