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General NPI Number Information
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NPI Number | 1518015106
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Entity Type | Organization
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Legal Business Name | BAY AREA FOOT & ANKLE INC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 501 VILLAGE GREEN PKWY STE 19
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City | BRADENTON
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State | FL
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Zip | 34209-3401
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Country | US
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Telephone | 941-795-4065
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Fax | 941-795-4073
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Provider Business Mailing Address
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Address Line | 501 VILLAGE GREEN PKWY STE 19
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City | BRADENTON
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State | FL
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Zip | 34209-3401
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Country | US
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Telephone | 941-795-4065
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Fax | 941-795-4073
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Authorized Official
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Title or Position | OWNER
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Name | MONA C WELCH
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Credential | DPM
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Telephone | 941-795-4065
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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 | PO2729
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License Number State | FL
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