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General NPI Number Information
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NPI Number | 1144439860
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Entity Type | Organization
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Legal Business Name | FLORIDA FOOT & ANKLE, LLC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3114 NE LOQUAT LN
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City | JENSEN BEACH
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State | FL
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Zip | 34957-5088
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Country | US
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Telephone | 772-334-5377
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Fax |
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Provider Business Mailing Address
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Address Line | 3114 NE LOQUAT LN
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City | JENSEN BEACH
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State | FL
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Zip | 34957-5088
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Country | US
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Telephone | 772-334-5377
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | STEPHEN J SPROHA
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Credential | DPM
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Telephone | 772-334-5377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO2736
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License Number State | FL
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