MEDICARE: CERTIFIED FOOT & ANKLE SPECIALISTS

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
2	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1629445275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CERTIFIED FOOT & ANKLE SPECIALISTS

Provider Business Mailing Address
First Line	:	PO BOX 812751
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33481-2751
Country	:	US
Telephone Number	:	561-357-9330
Fax Number	:	561-935-1583

Provider Business Practice Location Address
First Line	:	1521 FOREST HILL BLVD
Second Line	:	#4
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6031
Country	:	US
Telephone Number	:	561-357-9330
Fax Number	:	561-935-1583

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	BRANDON WEINSTOCK
Credential	:
Telephone Number	:	561-995-0229

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	10/09/2024

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