MEDICARE: FOOT TREATMENT 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

General Provider Information

NPI Number	:	1851407878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT TREATMENT CENTER, INC

Provider Business Mailing Address
First Line	:	1255 W 46TH ST STE 10
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3257
Country	:	US
Telephone Number	:	305-828-9383
Fax Number	:	305-822-0109

Provider Business Practice Location Address
First Line	:	1255 W 46TH ST STE 10
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3257
Country	:	US
Telephone Number	:	305-828-9383
Fax Number	:	305-822-0109

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SAMUEL GENDRIZ
Credential	:
Telephone Number	:	305-828-9383

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/22/2020

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Directions to “FOOT TREATMENT CENTER, INC ” Practice Location

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