Healthcare Provider Details

I. General information

NPI: 1134191117
Provider Name (Legal Business Name): THE CENTER FOR FOOT AND ANKLE MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5767 CURRY FORD ROAD
ORLANDO FL
32822
US

IV. Provider business mailing address

5767 CURRY FORD ROAD
ORLANDO FL
32822
US

V. Phone/Fax

Practice location:
  • Phone: 407-737-1518
  • Fax: 407-737-1198
Mailing address:
  • Phone: 407-737-1518
  • Fax: 407-737-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEOVANNY CHICO
Title or Position: VICE PRESIDENT
Credential: DPM
Phone: 407-737-1518