MEDICARE: FLORIDA FOOT & ANKLE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	PO2736	FL

General Provider Information

NPI Number	:	1144439860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA FOOT & ANKLE, LLC

Provider Business Mailing Address
First Line	:	3114 NE LOQUAT LN
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-5088
Country	:	US
Telephone Number	:	772-334-5377
Fax Number	:

Provider Business Practice Location Address
First Line	:	3114 NE LOQUAT LN
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-5088
Country	:	US
Telephone Number	:	772-334-5377
Fax Number	:

Authorized Official
Title or Position	:	PODIATRIST
Name	:	STEPHEN J SPROHA
Credential	:	DPM
Telephone Number	:	772-334-5377

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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