MEDICARE: PASCARELLA HOOVER FINKELSTEIN & WAGNER DPM PA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1125200001	OTHER	FL	DMERC NSC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	CM9370	OTHER	FL	MRR GROUP NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740275635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASCARELLA HOOVER FINKELSTEIN & WAGNER DPM PA

Provider Business Mailing Address
First Line	:	661 E ALTAMONTE DR
Second Line	:	SUITE 210
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5105
Country	:	US
Telephone Number	:	407-339-7759
Fax Number	:	407-830-0024

Provider Business Practice Location Address
First Line	:	661 E ALTAMONTE DR
Second Line	:	SUITE 210
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5105
Country	:	US
Telephone Number	:	407-339-7759
Fax Number	:	407-830-0024

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. BARBARA J WATSON
Credential	:
Telephone Number	:	407-339-7759

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	10/03/2017

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Directions to “PASCARELLA HOOVER FINKELSTEIN & WAGNER DPM PA ” Practice Location

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