Healthcare Provider Details

I. General information

NPI: 1265349435
Provider Name (Legal Business Name): FITZGERALD FOOT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 TURNPIKE RD STE 11
SOUTHBOROUGH MA
01772-2115
US

IV. Provider business mailing address

30 TURNPIKE RD STE 11
SOUTHBOROUGH MA
01772-2115
US

V. Phone/Fax

Practice location:
  • Phone: 508-444-2988
  • Fax:
Mailing address:
  • Phone: 508-444-2988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MELISSA FITZGERALD
Title or Position: OWNER
Credential:
Phone: 860-877-7754