Healthcare Provider Details

I. General information

NPI: 1720230485
Provider Name (Legal Business Name): FAMILY FOOT & ANKLE OF STUART PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 SE OCEAN BLVD SUITE 201
STUART FL
34996-3308
US

IV. Provider business mailing address

2220 SE OCEAN BLVD SUITE 201
STUART FL
34996-3308
US

V. Phone/Fax

Practice location:
  • Phone: 772-221-1193
  • Fax: 772-221-1152
Mailing address:
  • Phone: 772-221-1193
  • Fax: 772-221-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2822
License Number StateFL

VIII. Authorized Official

Name: DR. PAUL R SCHOPPE
Title or Position: DOCTOR
Credential: DPM
Phone: 772-221-1193