MEDICARE: FLORIDA FOOT AND ANKLE PHYSICIANS 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	213EP1101X	Primary Podiatric Medicine Podiatrist	P00001617	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	:	1770598617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA FOOT AND ANKLE PHYSICIANS PA

Provider Business Mailing Address
First Line	:	515 CAPE CORAL PARKWAY
Second Line	:	STE A
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8545
Country	:	US
Telephone Number	:	239-542-3581
Fax Number	:	239-542-4725

Provider Business Practice Location Address
First Line	:	515 CAPE CORAL PKWY E
Second Line	:	STE A
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8545
Country	:	US
Telephone Number	:	239-542-3581
Fax Number	:	239-542-4725

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PATRICIA PRICE
Credential	:
Telephone Number	:	239-542-3581

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	06/20/2014

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Directions to “FLORIDA FOOT AND ANKLE PHYSICIANS PA ” Practice Location

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