Provider Demographics
NPI:1780838656
Name:ATLANTIC FOOT AND ANKLE LLC
Entity Type:Organization
Organization Name:ATLANTIC FOOT AND ANKLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-852-8395
Mailing Address - Street 1:PO BOX 378485
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-8485
Mailing Address - Country:US
Mailing Address - Phone:305-444-7870
Mailing Address - Fax:305-444-7807
Practice Address - Street 1:475 BILTMORE WAY
Practice Address - Street 2:SUITE 402
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5755
Practice Address - Country:US
Practice Address - Phone:305-444-7870
Practice Address - Fax:305-444-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty