Healthcare Provider Details

I. General information

NPI: 1740275635
Provider Name (Legal Business Name): PASCARELLA HOOVER FINKELSTEIN & WAGNER DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 E ALTAMONTE DR SUITE 210
ALTAMONTE SPRINGS FL
32701-5105
US

IV. Provider business mailing address

661 E ALTAMONTE DR SUITE 210
ALTAMONTE SPRINGS FL
32701-5105
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-7759
  • Fax: 407-830-0024
Mailing address:
  • Phone: 407-339-7759
  • Fax: 407-830-0024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA J WATSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 407-339-7759