Provider Demographics
NPI:1871037267
Name:PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM PA
Entity Type:Organization
Organization Name:PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM PA
Other - Org Name:FOOT AND ANKLE ASSOCIATES OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:407-339-7759
Mailing Address - Street 1:661 E ALTAMONTE DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-339-7759
Mailing Address - Fax:407-915-5588
Practice Address - Street 1:1307 S INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 1061
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1413
Practice Address - Country:US
Practice Address - Phone:407-915-5587
Practice Address - Fax:407-915-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1125200004OtherMEDICARE NSC