NPI 1114487311 · live from the CMS NPI Registry
Abc Feet INC
Podiatrist, Foot & Ankle Surgery in Jacksonville, FL. National Provider Identifier 1114487311, active.
NPI record
| NPI | 1114487311 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 1126 University Blvd N, Jacksonville, FL 32211 |
| Practice phone | 904-765-5554 |
| Mailing address | 1629 Redstone Ct, St Augustine, FL 32092 |
| Enumerated | March 22, 2019 |
| Last updated | September 29, 2020 |
| Authorized official | Diandra Gordon, Owner/Provider |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.