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General NPI Number Information
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NPI Number | 1811032212
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Entity Type | Organization
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Legal Business Name | CENTER FOR ANKLE & FOOT CARE INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 3190 CITRUS TOWER BLVD STE A
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City | CLERMONT
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State | FL
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Zip | 34711-6886
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Country | US
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Telephone | 352-242-2502
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Fax | 352-242-0316
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Provider Business Mailing Address
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Address Line | 3190 CITRUS TOWER BLVD STE A
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City | CLERMONT
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State | FL
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Zip | 34711-6886
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Country | US
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Telephone | 352-242-2502
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Fax | 352-242-0316
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TIMOTHY JAMES HENNE
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Credential |
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Telephone | 352-242-2502
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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 | PO3047
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License Number State | FL
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