Provider Demographics
NPI:1043269947
Name:FOOT ANKLE & LEG SPECIALISTS OF SOUTH FLORIDA INC
Entity Type:Organization
Organization Name:FOOT ANKLE & LEG SPECIALISTS OF SOUTH FLORIDA INC
Other - Org Name:WESTON FOOT AND ANKLE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-349-2441
Mailing Address - Street 1:1600 TOWN CENTER BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3641
Mailing Address - Country:US
Mailing Address - Phone:954-349-2441
Mailing Address - Fax:954-349-7161
Practice Address - Street 1:1600 TOWN CENTER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3641
Practice Address - Country:US
Practice Address - Phone:954-349-2441
Practice Address - Fax:954-349-7161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001831213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40634Medicare ID - Type Unspecified
FL0969290001Medicare NSC
FL40634Medicare PIN