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General NPI Number Information
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NPI Number | 1033296173
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR FOOT AND ANKLE SURGERY
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 955 TOWN CENTER DR STE 100
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City | ORANGE CITY
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State | FL
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Zip | 32763-8255
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Country | US
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Telephone | 386-774-2200
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Fax | 386-774-2202
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Provider Business Mailing Address
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Address Line | 955 TOWN CENTER DR STE 100
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City | ORANGE CITY
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State | FL
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Zip | 32763-8255
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Country | US
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Telephone | 386-774-2200
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Fax | 867-742-2202
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ADAOBI OGUCHI
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Credential |
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Telephone | 386-774-2200
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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 | PO3038
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License Number State | FL
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