# FLORIDA FOOT & ANKLE GROUP PA

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

## Provider details

- **NPI number:** 1508183732
- **Authorized official:** DR. WALTER E ROTH III DPM (TREASURER)
- **Authorized official phone:** (407) 323-2566

## Contact information

- **Practice address:** 925 WILLISTON PARK PT, SUITE 1009, LAKE MARY, FL 32746-2114
- **Practice address phone:** (407) 323-2566
- **Practice address fax:** (407) 324-3577
- **Mailing address:** 522 S HUNT CLUB BLVD STE 344, APOPKA, FL 32703-4960
- **Mailing address phone:** (407) 323-2566
- **Mailing address fax:** (407) 324-3577

## Taxonomy

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

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 09/20/2014