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Organization
CORTEZ FOOT SURGERY CENTER, P.A.
Active
Organization
CORTEZ FOOT SURGERY CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARA L OLSON (CREDENTIALING)
(941) 758-4608
Entity
Organization
Contact information
Practice address
1800 CORTEZ RD W, SUITE B, BRADENTON, FL 34207-1335
(941) 758-4608
(941) 758-4438
Mailing address
1800 CORTEZ RD W, SUITE B, BRADENTON, FL 34207-1335
(941) 758-4608
(941) 758-4438
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1033
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490001091
RR MEDICARE INDIVIDUAL PROVIDER #
FL
01
—
CB2136
RR GROUP PROVIDER #
FL
Enumeration date
06/05/2006
Last updated
01/03/2020
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