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General NPI Number Information
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NPI Number | 1750725164
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Entity Type | Organization
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Legal Business Name | ON2FEET, L.L.C.
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 1319 S INTERNATIONAL PKWY SUITE 1161
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City | LAKE MARY
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State | FL
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Zip | 32746-1408
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Country | US
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Telephone | 407-391-3344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 470118
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City | LAKE MONROE
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State | FL
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Zip | 32747-0118
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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 | MGR
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Name | JEFFERSON J MENNUTI
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Credential | D.P.M.
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Telephone | 407-391-3344
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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 | PO3428
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License Number State | FL
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