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General NPI Number Information
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NPI Number | 1639235583
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Entity Type | Organization
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Legal Business Name | CENTER FOR FOOT AND ANKLE DISORDERS, P.A.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 8340 LAKEWOOD RANCH BLVD SUITE 320
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City | BRADENTON
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State | FL
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Zip | 34202-5183
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Country | US
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Telephone | 941-907-2676
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Fax | 941-907-2669
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Provider Business Mailing Address
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Address Line | 8340 LAKEWOOD RANCH BLVD SUITE 320
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City | BRADENTON
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State | FL
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Zip | 34202-5183
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Country | US
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Telephone | 941-907-2676
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Fax | 941-907-2669
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN CHRISTOPHER RELL
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Credential | DPM
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Telephone | 941-907-2676
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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 | PO2993
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License Number State | FL
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