MEDICARE: ANKLE & FOOT CENTER OF TAMPA BAY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	213ES0131X	Foot Surgery Podiatrist
2	213EP1101X	Primary Podiatric Medicine Podiatrist
3	213E00000X	Podiatrist
4	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1548430416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANKLE & FOOT CENTER OF TAMPA BAY

Provider Business Mailing Address
First Line	:	2835 W DE LEON ST
Second Line	:	SUITE #101
City	:	TAMPA
State	:	FL
Zip	:	33609-4130
Country	:	US
Telephone Number	:	813-254-4747
Fax Number	:	813-254-8262

Provider Business Practice Location Address
First Line	:	38105 13TH AVE
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-3437
Country	:	US
Telephone Number	:	813-715-4747
Fax Number	:	813-783-8937

Authorized Official
Title or Position	:	MEMBER
Name	:	ROBERT E CREIGHTON
Credential	:	DPM
Telephone Number	:	813-254-4747

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	10/11/2018

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Directions to “ANKLE & FOOT CENTER OF TAMPA BAY ” Practice Location

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