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General NPI Number Information
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NPI Number | 1306004130
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANKLE AND FOOT CARE CENTER PA
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 1608 W PLAZA DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5324
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Country | US
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Telephone | 850-942-2400
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Fax | 850-942-7714
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Provider Business Mailing Address
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Address Line | 1608 W PLAZA DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5324
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Country | US
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Telephone | 850-942-2400
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Fax | 850-942-7714
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANCY NELL FLESHER
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Credential |
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Telephone | 850-942-2400
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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 |
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License Number State | FL
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