Provider Demographics
NPI:1649844804
Name:GENESIS FOOT AND ANKLE INSTITUTE, INC.
Entity type:Organization
Organization Name:GENESIS FOOT AND ANKLE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:545-999-5379
Mailing Address - Street 1:4601 N CONGRESS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3381
Mailing Address - Country:US
Mailing Address - Phone:561-812-3762
Mailing Address - Fax:561-812-3763
Practice Address - Street 1:4601 N CONGRESS AVE STE 101
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3381
Practice Address - Country:US
Practice Address - Phone:561-812-3762
Practice Address - Fax:561-812-3763
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS FOOT AND ANKLE INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies