Provider Demographics
NPI:1356561377
Name:FLORIDA FOOT & ANKLE ASSOCIATES, LLC
Entity type:Organization
Organization Name:FLORIDA FOOT & ANKLE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-538-2226
Mailing Address - Street 1:8200 NW 27TH STREET
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1902
Mailing Address - Country:US
Mailing Address - Phone:786-662-3893
Mailing Address - Fax:786-662-3899
Practice Address - Street 1:601 N. FLAMINGO RD
Practice Address - Street 2:SUITE 414
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-888-1444
Practice Address - Fax:305-858-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390271400Medicaid
FLAC741OtherMEDICARE GROUP
FLAC741OtherMEDICARE GROUP
FL340635142Medicaid