Provider Demographics
NPI:1083892418
Name:FLORIDA FOOT CARE ASSOCIATES PA
Entity Type:Organization
Organization Name:FLORIDA FOOT CARE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARTA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:352-596-3338
Mailing Address - Street 1:5463 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1110
Mailing Address - Country:US
Mailing Address - Phone:352-596-3338
Mailing Address - Fax:352-597-3986
Practice Address - Street 1:5463 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1110
Practice Address - Country:US
Practice Address - Phone:352-596-3338
Practice Address - Fax:352-597-3986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1749213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029652000Medicaid
FLT84663Medicare UPIN
FL1036030001Medicare NSC
FL029652000Medicaid