Healthcare Provider Details
I. General information
NPI: 1437473816
Provider Name (Legal Business Name): CORTEZ FOOT & ANKLE SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2010
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8927 US HIGHWAY 301 N
PARRISH FL
34219-8701
US
IV. Provider business mailing address
8927 US HIGHWAY 301 N
PARRISH FL
34219-8701
US
V. Phone/Fax
- Phone: 941-776-5199
- Fax:
- Phone: 941-776-5199
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
BERKUN
Title or Position: PRESIDENT
Credential: DPM
Phone: 941-758-8818