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General NPI Number Information
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NPI Number | 1811177199
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA FOOT AND ANKLE ASSOCIATES PC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 6717 N.W. 11TH PLACE SUITE D
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City | GAINESVILLE
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State | FL
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Zip | 32605
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Country | US
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Telephone | 352-331-7543
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Fax | 352-331-7756
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Provider Business Mailing Address
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Address Line | 6717 N.W. 11TH PLACE SUITE D
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City | GAINESVILLE
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State | FL
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Zip | 32605
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Country | US
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Telephone | 352-331-7543
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Fax | 352-331-7756
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY WHYATT
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Credential | DPM
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Telephone | 352-331-7543
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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 | PO1605
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO2753
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License Number State | FL
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