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General NPI Number Information
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NPI Number | 1316144835
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Entity Type | Organization
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Legal Business Name | IXSA'S FOOT AND ANKLE INC
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 4343 W FLAGLER ST SUITE 400
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City | CORAL GABLES
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State | FL
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Zip | 33134-1586
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Country | US
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Telephone | 954-592-0898
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Fax |
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Provider Business Mailing Address
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Address Line | 1188 N STATE ROAD 7 APT 103
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City | LAUDERHILL
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State | FL
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Zip | 33313-6634
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Country | US
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Telephone | 954-592-0898
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IXSA TANYA GARCIA
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Credential | DPM
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Telephone | 952-592-0898
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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 | PO3300
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License Number State | FL
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