Healthcare Provider Details
I. General information
NPI: 1528035300
Provider Name (Legal Business Name): LIMONS FOOT & ANKLE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2006
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4614 26TH ST W
BRADENTON FL
34207
US
IV. Provider business mailing address
4614 26TH ST W
BRADENTON FL
34207
US
V. Phone/Fax
- Phone: 941-756-6906
- Fax: 941-751-0976
- Phone: 941-756-6906
- Fax: 941-751-0976
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LISA
M
GRIFFITH-LIMON
Title or Position: PHYSICIAN
Credential: DPM
Phone: 941-756-6906