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NPI Code Detail

MEDICARE: FLORIDA ORTHOPEDIC FOOT & ANKLE CENTER LLC

MEDICARE: FLORIDA ORTHOPEDIC FOOT & ANKLE CENTER 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
1213ES0103XFoot & Ankle Surgery PodiatristPO3305FL

General Provider Information

NPI Number : 1447616495
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA ORTHOPEDIC FOOT & ANKLE CENTER LLC
Provider Business Mailing Address
First Line : 1630 S TUTTLE AVE STE A
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3108
Country : US
Telephone Number : 941-924-8777
Fax Number :
Provider Business Practice Location Address
First Line : 1630 S TUTTLE AVE STE A
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3108
Country : US
Telephone Number : 941-924-8777
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JAMES M COTTOM
Credential :
Telephone Number : 941-924-8777
Provider Enumeration Date : 01/06/2016
Last Update Date : 06/03/2019

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Directions to “FLORIDA ORTHOPEDIC FOOT & ANKLE CENTER LLC ” Practice Location

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