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Organization
CENTRAL FLORIDA FOOT AND ANKLE
Active
Organization
CENTRAL FLORIDA FOOT AND ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TATIANA A WELLENS-BRUSCHAYT D.P.M, PHD (PRESIDENT)
(863) 299-4551
Entity
Organization
Contact information
Practice address
101 6TH ST NW, WINTER HAVEN, FL 33881-4630
(863) 299-4551
(863) 299-2310
Mailing address
PO BOX 7472, WINTER HAVEN, FL 33883-7472
(863) 299-4551
(863) 299-2310
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2760
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO2804
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3070
FL
Other
Enumeration date
10/03/2006
Last updated
03/07/2008
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