Provider Demographics
NPI:1235315789
Name:CENTRAL FLORIDA FOOT & ANKLE SPECIALISTS PA
Entity Type:Organization
Organization Name:CENTRAL FLORIDA FOOT & ANKLE SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:407-228-2838
Mailing Address - Street 1:899 OUTER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6688
Mailing Address - Country:US
Mailing Address - Phone:407-228-2838
Mailing Address - Fax:407-894-5151
Practice Address - Street 1:899 OUTER RD
Practice Address - Street 2:SUITE C
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6688
Practice Address - Country:US
Practice Address - Phone:407-228-2838
Practice Address - Fax:407-894-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-1882213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390000200Medicaid
FL390000200Medicaid
FLGO996AMedicare PIN