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General NPI Number Information
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NPI Number | 1235304387
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Entity Type | Organization
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Legal Business Name | VILLAGE FOOT & ANKLE P A
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 3200 COUNTY ROAD 507
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City | WILDWOOD
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State | FL
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Zip | 34785-8307
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Country | US
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Telephone | 352-391-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 COUNTY ROAD 507
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City | WILDWOOD
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State | FL
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Zip | 34785-8307
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Country | US
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Telephone | 352-391-4242
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. UYEN K DAO
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Credential | D.P.M.
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Telephone | 352-391-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO2852
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License Number State | FL
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