Provider Demographics
NPI:1639927478
Name:CORTEZ FOOT & ANKLE SPECIALISTS, PA
Entity type:Organization
Organization Name:CORTEZ FOOT & ANKLE SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:N
Authorized Official - Last Name:BERKUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:941-758-8818
Mailing Address - Street 1:1800 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-1335
Mailing Address - Country:US
Mailing Address - Phone:941-758-8818
Mailing Address - Fax:941-755-2901
Practice Address - Street 1:1722 DEL PRADO BLVD S STE 12
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-5523
Practice Address - Country:US
Practice Address - Phone:239-573-9200
Practice Address - Fax:855-376-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty