Provider Demographics
NPI:1013256106
Name:S F FOOT SPECIALIST, PLLC
Entity type:Organization
Organization Name:S F FOOT SPECIALIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:605-274-2564
Mailing Address - Street 1:PO BOX 89836
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57109-6836
Mailing Address - Country:US
Mailing Address - Phone:605-274-2564
Mailing Address - Fax:605-274-2562
Practice Address - Street 1:1320 S MINNESOTA AVE STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0656
Practice Address - Country:US
Practice Address - Phone:605-274-2564
Practice Address - Fax:605-274-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD209213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6832110001Medicare NSC