Healthcare Provider Details

I. General information

NPI: 1083892384
Provider Name (Legal Business Name): TOTAL FOOT AND ANKLE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10417 MOSS PARK ROAD
ORLANDO FL
32832
US

IV. Provider business mailing address

10417 MOSS PARK ROAD
ORLANDO FL
32832
US

V. Phone/Fax

Practice location:
  • Phone: 407-737-2751
  • Fax: 407-641-8515
Mailing address:
  • Phone: 407-737-2751
  • Fax: 407-641-8515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3278
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH A CONTE
Title or Position: MANAGER
Credential: DPM
Phone: 407-737-2751