# INDIAN RIVER PODIATRY, PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164443859
- **Authorized official:** MR. NICHOLAS WARD RUTLEDGE D.P.M. (OWNER)
- **Authorized official phone:** (772) 569-0081

## Contact information

- **Practice address:** 1880 37TH STREET, SUITE 4, VERO BEACH, FL 32960-4502
- **Practice address phone:** (772) 569-0081
- **Practice address fax:** (772) 569-0819
- **Mailing address:** PO BOX 99, VERO BEACH, FL 32961-0099
- **Mailing address phone:** (772) 569-0081
- **Mailing address fax:** (772) 569-0819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | P02624 | FL | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 07/25/2019