Healthcare Provider Details

I. General information

NPI: 1881918266
Provider Name (Legal Business Name): CORTEZ FOOT & ANKLE SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 75TH ST W
BRADENTON FL
34209-3201
US

IV. Provider business mailing address

315 75TH ST W
BRADENTON FL
34209-3201
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD BERKUN
Title or Position: PRESIDENT
Credential: DPM
Phone: 941-758-8818