Provider Demographics
NPI:1083843098
Name:CORAL GABLES FOOT AND ANKLE SPECIALISTS LLC
Entity Type:Organization
Organization Name:CORAL GABLES FOOT AND ANKLE SPECIALISTS LLC
Other - Org Name:ATLANTIC FOOT & ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-444-7870
Mailing Address - Street 1:401 MIRACLE MILE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4930
Mailing Address - Country:US
Mailing Address - Phone:305-444-7870
Mailing Address - Fax:305-444-7807
Practice Address - Street 1:401 MIRACLE MILE
Practice Address - Street 2:SUITE 310
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4930
Practice Address - Country:US
Practice Address - Phone:305-444-7870
Practice Address - Fax:305-444-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-11
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty