Healthcare Provider Details

I. General information

NPI: 1326384702
Provider Name (Legal Business Name): TEAM FEET INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR STE 4100
WEST PALM BCH FL
33401-3436
US

IV. Provider business mailing address

1411 N FLAGLER DR STE 4100
WEST PALM BCH FL
33401-3436
US

V. Phone/Fax

Practice location:
  • Phone: 561-659-3930
  • Fax: 561-833-1009
Mailing address:
  • Phone: 561-659-3930
  • Fax: 561-833-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO2462
License Number StateFL

VIII. Authorized Official

Name: SCOTT S STROLLA
Title or Position: PRESIDENT
Credential: DPM
Phone: 561-659-3930