Healthcare Provider Details

I. General information

NPI: 1215094776
Provider Name (Legal Business Name): CORTEZ FOOT & ANKLE SPECIALISTS P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 CORTEZ RD W
BRADENTON FL
34207-1335
US

IV. Provider business mailing address

1800 CORTEZ RD W
BRADENTON FL
34207-1335
US

V. Phone/Fax

Practice location:
  • Phone: 941-758-8818
  • Fax: 941-755-2901
Mailing address:
  • Phone: 941-758-8818
  • Fax: 941-758-4438

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: CARA L OLSON
Title or Position: OFFICE SUPPORT MANANGER
Credential:
Phone: 941-758-8818