Provider Demographics
NPI:1396354478
Name:SOUTH FLORIDA FOOT & ANKLE CENTER
Entity type:Organization
Organization Name:SOUTH FLORIDA FOOT & ANKLE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-793-6170
Mailing Address - Street 1:11412 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8722
Mailing Address - Country:US
Mailing Address - Phone:561-793-6170
Mailing Address - Fax:
Practice Address - Street 1:13550 S JOG RD STE 100
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3808
Practice Address - Country:US
Practice Address - Phone:561-793-6170
Practice Address - Fax:561-795-3683
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH FLORIDA FOOT & ANKLE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies