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General NPI Number Information
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NPI Number | 1700691672
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Entity Type | Organization
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Legal Business Name | PREMIER PODIATRY ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 616 E ALTAMONTE DR. STE #205
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4810
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Country | US
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Telephone | 407-813-2413
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Fax | 407-792-1019
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Provider Business Mailing Address
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Address Line | 616 E ALTAMONTE DR STE 205
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4810
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Country | US
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Telephone | 407-813-2413
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Fax | 407-378-6017
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CRISTINA MARIA CORRALES-AGUILAR
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Credential |
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Telephone | 407-813-2413
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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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Taxonomy #2
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Taxonomy Code | 213EP0504X
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Taxonomy Name | Public Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #7
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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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