Provider Demographics
NPI:1821557505
Name:SEGALL FOOT & ANKLE INC
Entity Type:Organization
Organization Name:SEGALL FOOT & ANKLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FENELON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:954-384-2555
Mailing Address - Street 1:2825 N STATE ROAD 7 STE 204
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5737
Mailing Address - Country:US
Mailing Address - Phone:954-580-4080
Mailing Address - Fax:954-580-4081
Practice Address - Street 1:2825 N STATE ROAD 7 STE 204
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-580-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1647457OtherUHC