MEDICARE: NAPLES FOOT DOCTOR, 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	261QP1100X	Podiatric Clinic/Center	PO3399	FL

General Provider Information

NPI Number	:	1629349840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPLES FOOT DOCTOR, LLC

Provider Business Mailing Address
First Line	:	5490 BRYSON DR
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34109-0924
Country	:	US
Telephone Number	:	239-325-8717
Fax Number	:	866-214-2666

Provider Business Practice Location Address
First Line	:	5490 BRYSON DR
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34109-0924
Country	:	US
Telephone Number	:	239-325-8717
Fax Number	:	866-214-2666

Authorized Official
Title or Position	:	CEO
Name	:	DR. ELIOT SHERR
Credential	:	DPM
Telephone Number	:	978-531-4484

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	01/19/2012

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Directions to “NAPLES FOOT DOCTOR, LLC ” Practice Location

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