MEDICARE: FAMILY FOOT AND ANKLE CENTER, INC.

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	213E00000X	Podiatrist	200114714	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720099435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FOOT AND ANKLE CENTER, INC.

Provider Business Mailing Address
First Line	:	5928 OKEECHOBEE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-4324
Country	:	US
Telephone Number	:	561-471-8004
Fax Number	:	561-471-9304

Provider Business Practice Location Address
First Line	:	5928 OKEECHOBEE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-4324
Country	:	US
Telephone Number	:	561-471-8004
Fax Number	:	561-471-9304

Authorized Official
Title or Position	:	PHYSICIAN PRESIDENT FAMILY FOOT
Name	:	DR. GLENN ALAN RISPLER
Credential	:	DPM
Telephone Number	:	561-471-8004

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	05/14/2008

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