MEDICARE: ATLANTIC FOOT AND 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	:	1619149788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC FOOT AND ANKLE LLC

Provider Business Mailing Address
First Line	:	PO BOX 378485
Second Line	:
City	:	KEY LARGO
State	:	FL
Zip	:	33037-8485
Country	:	US
Telephone Number	:	305-852-8395
Fax Number	:	305-852-8397

Provider Business Practice Location Address
First Line	:	92410 OVERSEAS HWY
Second Line	:	SUITE 1
City	:	TAVERNIER
State	:	FL
Zip	:	33070-2636
Country	:	US
Telephone Number	:	305-942-9842
Fax Number	:

Authorized Official
Title or Position	:	MGRM
Name	:	DR. BRIGETTE SMITH
Credential	:	DPM
Telephone Number	:	305-852-8395

Provider Enumeration Date	:	03/29/2008
Last Update Date	:	10/24/2008

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