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General NPI Number Information
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NPI Number | 1518602317
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Entity Type | Organization
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Legal Business Name | PRESTIGE FOOT & ANKLE CENTER LLC
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 535 E SMITH RD
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City | MEDINA
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State | OH
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Zip | 44256-2637
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Country | US
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Telephone | 330-591-9635
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Fax |
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Provider Business Mailing Address
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Address Line | 784 MEDINA RD STE 107
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City | MEDINA
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State | OH
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Zip | 44256-9634
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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 | OWNER
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Name | RICHARD C LIMPEROS
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Credential |
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Telephone | 330-591-9635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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