MEDICARE: MERRITT ISLAND FOOT & ANKLE INC

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	213ES0103X	Foot & Ankle Surgery Podiatrist	PO1928	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427236199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERRITT ISLAND FOOT & ANKLE INC

Provider Business Mailing Address
First Line	:	2404 N COURTENAY PKWY
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-4191
Country	:	US
Telephone Number	:	321-452-1327
Fax Number	:	321-454-9208

Provider Business Practice Location Address
First Line	:	2404 N COURTENAY PKWY
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-4191
Country	:	US
Telephone Number	:	321-452-1327
Fax Number	:	321-454-9208

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK BEYLIN
Credential	:	D.P.M.
Telephone Number	:	321-452-1327

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/24/2016

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Directions to “MERRITT ISLAND FOOT & ANKLE INC ” Practice Location

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