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General NPI Number Information
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NPI Number | 1275206625
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Entity Type | Organization
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Legal Business Name | JPL FOOT AND ANKLE SPECIALISTS LLC
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 1300 3RD ST SW # 105
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3913
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Country | US
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Telephone | 917-482-1347
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Fax | 866-864-8671
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Provider Business Mailing Address
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Address Line | 1300 3RD ST SW # 105
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3913
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Country | US
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Telephone |
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Fax | 866-864-8671
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Authorized Official
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Title or Position | OWNER
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Name | JESSY PIERRE-LOUIS
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Credential | DPM
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Telephone | 917-482-1347
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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 |
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License Number State |
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