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General NPI Number Information
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NPI Number | 1508887704
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANKLE & FOOT CENTER OF FLORIDA INC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 1509 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-2116
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Country | US
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Telephone | 407-836-6155
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Fax | 407-839-0189
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Provider Business Mailing Address
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Address Line | 3670 MAGUIRE BLVD SUITE 220
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City | ORLANDO
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State | FL
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Zip | 32803-3071
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Country | US
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Telephone | 407-423-1234
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Fax | 407-517-1040
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Authorized Official
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Title or Position | CEO
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Name | GREGORY J RENTON
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Credential |
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Telephone | 407-423-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 740
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License Number State | FL
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