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General NPI Number Information
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NPI Number | 1093266991
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Entity Type | Organization
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Legal Business Name | FLORIDA FOOT AND ANKLE SPECIALISTS PA
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 700 2ND AVE N SUITE 204
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City | NAPLES
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State | FL
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Zip | 34102-5756
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Country | US
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Telephone | 239-272-1185
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Fax | 239-431-7942
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Provider Business Mailing Address
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Address Line | 1130 CREEKSIDE PKWY #111324
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City | NAPLES
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State | FL
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Zip | 34108-1100
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Country | US
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Telephone | 239-272-1185
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Fax | 239-431-7942
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A CRIST
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Credential | DPM
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Telephone | 239-272-1185
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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 | PO 1768
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License Number State | FL
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