Provider Demographics
NPI:1881882116
Name:WORMAN FOOT AND ANKLE ASSOCIATES LLC
Entity type:Organization
Organization Name:WORMAN FOOT AND ANKLE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-547-0000
Mailing Address - Street 1:7500 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1437
Mailing Address - Country:US
Mailing Address - Phone:727-547-4700
Mailing Address - Fax:727-547-0008
Practice Address - Street 1:7500 BRYAN DAIRY RD
Practice Address - Street 2:SUITE B
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1437
Practice Address - Country:US
Practice Address - Phone:727-547-4700
Practice Address - Fax:727-547-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3196213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6002680001Medicare NSC