Provider Demographics
NPI:1659397107
Name:FAMILY FOOT AND ANKLE LLC
Entity Type:Organization
Organization Name:FAMILY FOOT AND ANKLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-867-0024
Mailing Address - Street 1:2825 SE 3RD COURT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8310
Mailing Address - Country:US
Mailing Address - Phone:352-867-0024
Mailing Address - Fax:352-867-0029
Practice Address - Street 1:2825 SE 3RD CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0444
Practice Address - Country:US
Practice Address - Phone:352-867-0024
Practice Address - Fax:352-867-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9426Medicare ID - Type Unspecified
FL5897830001Medicare NSC