Healthcare Provider Details

I. General information

NPI: 1639639651
Provider Name (Legal Business Name): FLORIDA FOOT & ANKLE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 13TH ST STE 106
BOCA RATON FL
33486-2350
US

IV. Provider business mailing address

8200 NW 27TH ST STE 108
DORAL FL
33122-1902
US

V. Phone/Fax

Practice location:
  • Phone: 561-826-7032
  • Fax: 561-826-8591
Mailing address:
  • Phone: 786-662-3893
  • Fax: 786-662-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD L SEDA
Title or Position: PRESIDENT
Credential:
Phone: 305-538-2226