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NPI Code Detail

MEDICARE: EXCEL PODIATRY LLC

MEDICARE: EXCEL PODIATRY 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
1213E00000XPodiatrist36003404OH

General Provider Information

NPI Number : 1750816005
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCEL PODIATRY LLC
Provider Business Mailing Address
First Line : 6200 PLEASANT AVE
Second Line : STE 3
City : FAIRFIELD
State : OH
Zip : 45014-4670
Country : US
Telephone Number : 513-829-9333
Fax Number : 513-858-7827
Provider Business Practice Location Address
First Line : 6200 PLEASANT AVE
Second Line : STE 3
City : FAIRFIELD
State : OH
Zip : 45014-4670
Country : US
Telephone Number : 513-829-9333
Fax Number : 513-858-7827
Authorized Official
Title or Position : OWNER
Name : TIFFANY ORLANDO-WEBER
Credential : DPM
Telephone Number : 216-534-2773
Provider Enumeration Date : 04/25/2017
Last Update Date : 05/31/2017

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Directions to “EXCEL PODIATRY LLC ” Practice Location

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