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General NPI Number Information
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NPI Number | 1023749181
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Entity Type | Organization
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Legal Business Name | NJC FOOT & ANKLE SURGICAL SPECIALISTS
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 9600 NE 2ND AVE
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2722
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Country | US
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Telephone | 305-712-6395
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Fax | 305-630-8590
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Provider Business Mailing Address
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Address Line | 15773 NW 3RD ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1588
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Country | US
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Telephone | 305-712-6395
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Fax | 305-630-8590
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS J CORETTI
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Credential | DPM
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Telephone | 305-712-6395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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