Provider Demographics
NPI:1477010734
Name:DOC 2 U MOBILE PODIATRY
Entity Type:Organization
Organization Name:DOC 2 U MOBILE PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMOUZEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:863-701-4172
Mailing Address - Street 1:10522 CEDAR FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6151
Mailing Address - Country:US
Mailing Address - Phone:863-701-4172
Mailing Address - Fax:352-414-5644
Practice Address - Street 1:10522 CEDAR FOREST CIR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6151
Practice Address - Country:US
Practice Address - Phone:863-701-4172
Practice Address - Fax:352-414-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric