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General NPI Number Information
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NPI Number | 1134191117
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR FOOT AND ANKLE MEDICINE PA
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 5767 CURRY FORD ROAD
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City | ORLANDO
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State | FL
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Zip | 32822
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Country | US
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Telephone | 407-737-1518
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Fax | 407-737-1198
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Provider Business Mailing Address
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Address Line | 5767 CURRY FORD ROAD
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City | ORLANDO
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State | FL
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Zip | 32822
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Country | US
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Telephone | 407-737-1518
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Fax | 407-737-1198
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. GEOVANNY CHICO
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Credential | DPM
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Telephone | 407-737-1518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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