Provider Demographics
NPI:1780638361
Name:THE FOOT & ANKLE INSTITUTE OF SOUTH FLORIDA, INC
Entity Type:Organization
Organization Name:THE FOOT & ANKLE INSTITUTE OF SOUTH FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:HANFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-662-1444
Mailing Address - Street 1:7000 SW 62ND AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4716
Mailing Address - Country:US
Mailing Address - Phone:305-662-1444
Mailing Address - Fax:305-667-6086
Practice Address - Street 1:7000 SW 62ND AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:305-662-1444
Practice Address - Fax:305-675-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1940213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45674OtherBCBS
FL5630OtherMEDICARE RAILROAD
FL5630OtherMEDICARE RAILROAD
FL65130XMedicare PIN
FL45674OtherBCBS
FLK0234Medicare PIN