Healthcare Provider Details
I. General information
NPI: 1649601832
Provider Name (Legal Business Name): THE FOOT AND ANKLE INSTITUTE OF SOUTH FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2013
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
- Phone: 305-662-1444
- Fax: 305-667-6086
- Phone: 305-662-1444
- Fax: 305-667-6086
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | PO3312 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
MANUEL
RODRIGUEZ
Title or Position: PRESIDENT
Credential: DPM
Phone: 305-662-1444