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General NPI Number Information
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NPI Number | 1811929250
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Entity Type | Organization
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Legal Business Name | PALMETTO PODIATRY INSTITUTE P A
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 7100 W 20TH AVE SUITE 200
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City | HIALEAH
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State | FL
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Zip | 33016-5529
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Country | US
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Telephone | 305-823-1629
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 W 20TH AVE SUITE 200
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City | HIALEAH
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State | FL
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Zip | 33016-5529
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Country | US
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Telephone | 305-823-1629
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FREDERICK J SCAVONE
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Credential | DPM
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Telephone | 305-823-1629
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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 | PO0002337
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License Number State | FL
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