Healthcare Provider Details

I. General information

NPI: 1053596197
Provider Name (Legal Business Name): FOOT AND ANKLE CENTER OF OCALA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 SW HIGHWAY 200 SUITE 100
OCALA FL
34476-8307
US

IV. Provider business mailing address

6160 SW HIGHWAY 200 SUITE 100
OCALA FL
34476-8307
US

V. Phone/Fax

Practice location:
  • Phone: 352-861-1055
  • Fax: 352-854-6743
Mailing address:
  • Phone: 352-861-1055
  • Fax: 352-854-6743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO-0002122
License Number StateFL

VIII. Authorized Official

Name: ROBERT F LINN JR.
Title or Position: OWNER
Credential: D.P.M.
Phone: 352-861-1055