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General NPI Number Information
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NPI Number | 1790977171
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Entity Type | Individual
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Provider Name | CARLO ANTHONY MESSINA DPM
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Gender | Male
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 1839 N 78TH AVE
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-3638
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Country | US
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Telephone | 847-933-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 TOWN CENTER BLVD SUITE C
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City | WESTON
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State | FL
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Zip | 33326
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Country | US
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Telephone | 954-349-2441
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Fax | 954-349-7161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 135.000613
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License Number State | IL
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