MEDICARE: FLY 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	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1538027909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLY FOOT & ANKLE LLC

Provider Business Mailing Address
First Line	:	6240 HAMILTON AVE STE 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 HAMILTON AVE STE 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2000
Country	:	US
Telephone Number	:	513-541-7325
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY FLEY
Credential	:	DPM
Telephone Number	:	513-266-7013

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/14/2026

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