Provider Demographics
NPI:1912199076
Name:SCHOLL FOOT CARE PA
Entity Type:Organization
Organization Name:SCHOLL FOOT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHOLL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:352-753-5600
Mailing Address - Street 1:1501 N US HIGHWAY 441
Mailing Address - Street 2:SUITE 1304
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8999
Mailing Address - Country:US
Mailing Address - Phone:352-753-5600
Mailing Address - Fax:352-750-3365
Practice Address - Street 1:1501 N US HIGHWAY 441
Practice Address - Street 2:SUITE 1304
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8999
Practice Address - Country:US
Practice Address - Phone:352-753-5600
Practice Address - Fax:352-750-3365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2149213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDQ9914OtherRAILROAD MEDICARE
FL1076320001Medicare NSC
FLEC306AMedicare PIN
FLDQ9914OtherRAILROAD MEDICARE