Healthcare Provider Details

I. General information

NPI: 1780638361
Provider Name (Legal Business Name): THE FOOT & ANKLE INSTITUTE OF SOUTH FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

IV. Provider business mailing address

7001 SW 61ST AVE
SOUTH MIAMI FL
33143-3420
US

V. Phone/Fax

Practice location:
  • Phone: 305-662-1444
  • Fax: 305-667-6086
Mailing address:
  • Phone: 305-662-1444
  • Fax: 305-667-6086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO1940
License Number StateFL

VIII. Authorized Official

Name: MANUEL RODRIGUEZ
Title or Position: PRESIDENT
Credential: DPM
Phone: 305-662-1444