Healthcare Provider Details

I. General information

NPI: 1235315789
Provider Name (Legal Business Name): CENTRAL FLORIDA FOOT & ANKLE SPECIALISTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 OUTER RD SUITE C
ORLANDO FL
32814-6688
US

IV. Provider business mailing address

899 OUTER RD SUITE C
ORLANDO FL
32814-6688
US

V. Phone/Fax

Practice location:
  • Phone: 407-228-2838
  • Fax: 407-894-5151
Mailing address:
  • Phone: 407-228-2838
  • Fax: 407-894-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO-1882
License Number StateFL

VIII. Authorized Official

Name: DR. VICTOR FRANCIS MCNAMARA
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 407-228-2838