Organization Name: | ORLANDO FOOT & ANKLE CLINIC INC |
NPI Number: | 1053420836 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREGORY RENTON (CEO) |
Mailing Address: | 1381 Citrus Tower Blvd Ste 103 Clermont |
State: | FL US |
Postal Code: | 347111957 |
Phone Number: | 3522437066 |
Fax Number: | 3522437008 |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |