Provider Demographics
NPI:1235477555
Name:JENNY ADAMS, PA
Entity Type:Organization
Organization Name:JENNY ADAMS, PA
Other - Org Name:ADAMS FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:239-260-7476
Mailing Address - Street 1:3435 PINE RIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3828
Mailing Address - Country:US
Mailing Address - Phone:239-260-7476
Mailing Address - Fax:239-260-7608
Practice Address - Street 1:3435 PINE RIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-3828
Practice Address - Country:US
Practice Address - Phone:239-300-9703
Practice Address - Fax:239-206-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-21
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3507213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008828100Medicaid
FLGY853AMedicare UPIN