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General NPI Number Information
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NPI Number | 1912483975
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Entity Type | Organization
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Legal Business Name | ASENCIO FOOT AND ANKLE LLC
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 16800 NW 2ND AVE STE 202
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169
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Country | US
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Telephone | 305-693-7287
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Fax |
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Provider Business Mailing Address
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Address Line | 8932 NW 187TH ST
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City | HIALEAH
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State | FL
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Zip | 33018-6280
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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 | MANAGING EMPLOYEE
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Name | BRIAN ASENCIO
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Credential | DPM
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Telephone | 305-283-3656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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