Provider Demographics
NPI:1326242637
Name:FOOT AND ANKLE CENTER, INC.
Entity Type:Organization
Organization Name:FOOT AND ANKLE CENTER, INC.
Other - Org Name:RICHARD S. BENJAMIN, DPM, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:352-259-9288
Mailing Address - Street 1:3911 SE 44TH STREET
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480
Mailing Address - Country:US
Mailing Address - Phone:352-259-9288
Mailing Address - Fax:
Practice Address - Street 1:929 N. US HIGHWAY 441
Practice Address - Street 2:SUITE 202
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-259-9288
Practice Address - Fax:352-245-9563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty