Provider Demographics
NPI:1942495445
Name:LONGWOOD FOOT & ANKLE PHYSICIAN PA
Entity Type:Organization
Organization Name:LONGWOOD FOOT & ANKLE PHYSICIAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DACIA
Authorized Official - Middle Name:FELIX
Authorized Official - Last Name:MILESCU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:407-695-1984
Mailing Address - Street 1:1441 LANGHAM TER
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1967
Mailing Address - Country:US
Mailing Address - Phone:407-739-7183
Mailing Address - Fax:
Practice Address - Street 1:521 W STATE ROAD 434
Practice Address - Street 2:SUITE 300
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4984
Practice Address - Country:US
Practice Address - Phone:407-695-1984
Practice Address - Fax:407-332-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-09
Last Update Date:2007-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3179213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty