Provider Demographics
NPI:1649250887
Name:REIFSCHNEIDER, RONALD ALAN (DPM)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ALAN
Last Name:REIFSCHNEIDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4120 TAMIAMI TRL
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-9200
Mailing Address - Country:US
Mailing Address - Phone:941-743-3668
Mailing Address - Fax:941-743-0098
Practice Address - Street 1:4120 TAMIAMI TRL
Practice Address - Street 2:SUITE D-2
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9200
Practice Address - Country:US
Practice Address - Phone:941-743-3668
Practice Address - Fax:941-743-0098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO994213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87993Medicare ID - Type Unspecified