Provider Demographics
NPI:1033710744
Name:ANCLOTE PODIATRY, INC.
Entity Type:Organization
Organization Name:ANCLOTE PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ROEVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-937-6398
Mailing Address - Street 1:42674 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-6211
Mailing Address - Country:US
Mailing Address - Phone:727-937-6398
Mailing Address - Fax:727-937-6568
Practice Address - Street 1:1264 S PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3720
Practice Address - Country:US
Practice Address - Phone:727-937-6398
Practice Address - Fax:727-937-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty