Provider Demographics
NPI:1245554021
Name:PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM, PA
Entity type:Organization
Organization Name:PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:352-589-9550
Mailing Address - Street 1:1807 SALK AVE
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4311
Mailing Address - Country:US
Mailing Address - Phone:352-589-9550
Mailing Address - Fax:
Practice Address - Street 1:1807 SALK AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4311
Practice Address - Country:US
Practice Address - Phone:352-589-9550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1125200002OtherDMERC NSC
1125200002OtherDMERC NSC