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Organization
SON SHINE FOOT AND ANKLE CENTER INC
Active
Organization
SON SHINE FOOT AND ANKLE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT ANDREW DERRICO DPM (PHYSICIAN)
(772) 380-0900
Entity
Organization
Contact information
Practice address
1405 SE GOLDTREE DR, SUITE B, PORT ST LUCIE, FL 34952-7563
(772) 380-0900
(772) 380-0901
Mailing address
PO BOX 8210, PORT ST LUCIE, FL 34985-8210
(772) 380-0900
(772) 380-0901
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2649
FL
Other
Enumeration date
06/01/2006
Last updated
01/03/2008
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