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General NPI Number Information
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NPI Number | 1477102846
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Entity Type | Organization
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Legal Business Name | FAMILY PODIATRY OF CENTRAL FLORIDA PA
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 11616 LAKE UNDERHILL RD STE 205
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City | ORLANDO
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State | FL
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Zip | 32825-4466
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Country | US
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Telephone | 407-647-2346
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Fax |
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Provider Business Mailing Address
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Address Line | 525 TECHNOLOGY PARK
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City | LAKE MARY
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State | FL
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Zip | 32746-7107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KELLI KAPLAN
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Credential |
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Telephone | 407-461-4499
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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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