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NPI Code Detail

MEDICARE: ORLANDO FOOT AND ANKLE CLINIC, INC

MEDICARE: ORLANDO FOOT AND ANKLE CLINIC, INC
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 Podiatrist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DB3528OTHERFLR/R MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114003274
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORLANDO FOOT AND ANKLE CLINIC, INC
Provider Business Mailing Address
First Line : P O BOX 140233
Second Line :
City : ORLANDO
State : FL
Zip : 32814-0233
Country : US
Telephone Number : 407-423-1234
Fax Number : 407-517-1040
Provider Business Practice Location Address
First Line : 1307 S INTERNATIONAL PKWY STE 1061
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-1412
Country : US
Telephone Number : 407-323-1234
Fax Number : 407-322-8523
Authorized Official
Title or Position : CEO
Name : GREGORY RENTON
Credential :
Telephone Number : 407-423-1234
Provider Enumeration Date : 10/31/2006
Last Update Date : 11/02/2020

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Directions to “ORLANDO FOOT AND ANKLE CLINIC, INC ” Practice Location

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