Healthcare Provider Details

I. General information

NPI: 1316334105
Provider Name (Legal Business Name): FLORIDA FOOT & ANKLE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10621 N KENDALL DR STE 213
MIAMI FL
33176-1930
US

IV. Provider business mailing address

8200 NW 27 ST STE 108
DORAL FL
33122-1906
US

V. Phone/Fax

Practice location:
  • Phone: 786-464-0631
  • Fax: 786-762-2632
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: DPM
Phone: 305-538-2226