MEDICARE: WORMAN FOOT AND ANKLE ASSOCIATES

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3196	FL

General Provider Information

NPI Number	:	1093990376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORMAN FOOT AND ANKLE ASSOCIATES

Provider Business Mailing Address
First Line	:	9726 TAYLOR ROSE LN
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-2288
Country	:	US
Telephone Number	:	727-547-0000
Fax Number	:	727-547-0008

Provider Business Practice Location Address
First Line	:	7500 BRYAN DAIRY RD
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-1437
Country	:	US
Telephone Number	:	727-547-0000
Fax Number	:	727-547-0008

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY ANDREW WORMAN
Credential	:	DPM
Telephone Number	:	727-547-0000

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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Practice Fax:

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