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Organization
FLORIDA FOOT & ANKLE GROUP PA
Active
Organization
FLORIDA FOOT & ANKLE GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER E ROTH III DPM (TREASURER)
(407) 323-2566
Entity
Organization
Contact information
Practice address
925 WILLISTON PARK PT, SUITE 1009, LAKE MARY, FL 32746-2114
(407) 323-2566
(407) 324-3577
Mailing address
522 S HUNT CLUB BLVD, #344, APOPKA, FL 32703-4960
(407) 323-2566
(407) 296-6272
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Enumeration date
07/17/2006
Last updated
04/06/2024
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