Healthcare Provider Details

I. General information

NPI: 1083843098
Provider Name (Legal Business Name): CORAL GABLES FOOT AND ANKLE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2009
Last Update Date: 07/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MIRACLE MILE SUITE 310
CORAL GABLES FL
33134-4930
US

IV. Provider business mailing address

401 MIRACLE MILE SUITE 310
CORAL GABLES FL
33134-4930
US

V. Phone/Fax

Practice location:
  • Phone: 305-444-7870
  • Fax: 305-444-7807
Mailing address:
  • Phone: 305-444-7870
  • Fax: 305-444-7807

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: DR. BRIGETTE E SMITH
Title or Position: PRESIDENT
Credential: DPM
Phone: 305-444-7870