Provider Demographics
NPI:1326364985
Name:NORTH MIAMI FOOT & ANKLE CENTER INC.
Entity Type:Organization
Organization Name:NORTH MIAMI FOOT & ANKLE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:G
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-893-9883
Mailing Address - Street 1:12605 NE 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4813
Mailing Address - Country:US
Mailing Address - Phone:305-893-9883
Mailing Address - Fax:
Practice Address - Street 1:12605 NE 7TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4813
Practice Address - Country:US
Practice Address - Phone:305-893-9883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2398213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390145900Medicaid