MEDICARE: MIRAMAR PODIATRY AND SURGERY INSTITUTE LLC

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	213ES0131X	Foot Surgery Podiatrist	PO 3243	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1427166594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRAMAR PODIATRY AND SURGERY INSTITUTE LLC

Provider Business Mailing Address
First Line	:	8910 MIRAMAR PKWY
Second Line	:	SUITE 117
City	:	MIRAMAR
State	:	FL
Zip	:	33025-4100
Country	:	US
Telephone Number	:	954-442-6100
Fax Number	:	954-442-6202

Provider Business Practice Location Address
First Line	:	8910 MIRAMAR PKWY
Second Line	:	SUITE 117
City	:	MIRAMAR
State	:	FL
Zip	:	33025-4100
Country	:	US
Telephone Number	:	954-442-6100
Fax Number	:	954-442-6202

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. NANCY ALEXIS-CALIXTE
Credential	:	DPM
Telephone Number	:	954-442-6100

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	03/20/2012

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Directions to “MIRAMAR PODIATRY AND SURGERY INSTITUTE LLC ” Practice Location

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