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General NPI Number Information
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NPI Number | 1740991363
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Entity Type | Organization
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Legal Business Name | FLORIDA ANKLE AND FOOT ASSOCIATES
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Dates
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Enumeration Date | 12/06/2022
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Last Update Date | 12/06/2022
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Provider Practice Location Address
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Address Line | 700 2ND AVE N STE 204
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City | NAPLES
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State | FL
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Zip | 34102-5701
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Country | US
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Telephone | 239-272-1185
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Fax | 718-732-2063
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Provider Business Mailing Address
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Address Line | PO BOX 111324
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City | NAPLES
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State | FL
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Zip | 34108-0123
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Country | US
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Telephone | 239-272-1185
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Fax | 718-732-2063
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A CRIST
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Credential | DPM
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Telephone | 239-272-1185
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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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