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General NPI Number Information
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NPI Number | 1326058249
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Entity Type | Organization
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Legal Business Name | GENTLE FOOT CARE CLINIC, PA
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 01/03/2023
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Provider Practice Location Address
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Address Line | 38192 MEDICAL CENTER AVE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540-1380
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Country | US
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Telephone | 813-782-3233
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Fax | 813-502-5904
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Provider Business Mailing Address
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Address Line | 38192 MEDICAL CENTER AVE.
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540
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Country | US
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Telephone | 813-782-3233
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Fax | 813-782-5332
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | JAIRO B CRUZ
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Credential | DPM
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Telephone | 813-782-3233
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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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Taxonomy #2
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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 |
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