Organization Name: | S F FOOT SPECIALIST, PLLC |
NPI Number: | 1013256106 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GABRIEL R RODRIGUEZ (OWNER/PHYSICIAN) |
Mailing Address: | 3900 W 41st Street Sioux Falls |
State: | SD US |
Postal Code: | 571060715 |
Phone Number: | 6052752564 |
Fax Number: | 6052752562 |
NPI Enumeration Date: | 02/08/2013 |
NPI Last Update Date: | 03/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 209 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |