Healthcare Provider Details

I. General information

NPI: 1013258953
Provider Name (Legal Business Name): CRIGLER FOOT & ANKLE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 08/21/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 MAITLAND AVE SUITE 206
ALTAMONTE SPRINGS FL
32701-4810
US

IV. Provider business mailing address

251 MAITLAND AVE SUITE 206
ALTAMONTE SPRINGS FL
32701-4810
US

V. Phone/Fax

Practice location:
  • Phone: 407-331-3668
  • Fax: 407-331-3700
Mailing address:
  • Phone: 407-331-3668
  • Fax: 407-331-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO 3242
License Number StateFL

VIII. Authorized Official

Name: DR. LISA BETH CRIGLER
Title or Position: PODIATRIST
Credential: DPM
Phone: 407-331-3668