Provider Demographics
NPI:1073566154
Name:WEST CENTRAL PODIATRY CONSULTANTS, P.L.
Entity Type:Organization
Organization Name:WEST CENTRAL PODIATRY CONSULTANTS, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEROFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-398-6650
Mailing Address - Street 1:10863 PARK BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-5423
Mailing Address - Country:US
Mailing Address - Phone:727-398-6650
Mailing Address - Fax:727-398-6550
Practice Address - Street 1:10875 PARK BLVD
Practice Address - Street 2:STE. C
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772
Practice Address - Country:US
Practice Address - Phone:727-398-6650
Practice Address - Fax:727-398-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2903213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU84865Medicare UPIN
FLU85614Medicare UPIN
FL3980150001Medicare NSC
FLE5736ZMedicare ID - Type Unspecified
FL65687ZMedicare ID - Type Unspecified