Organization
FLORIDA FOOT & ANKLE GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER E ROTH III D.P.M. (TREASURER)
(407) 323-2566
Entity
Organization
Contact information
Practice address
178 WILSHIRE BLVD, CASSELBERRY, FL 32707-5352
(407) 671-8010
(407) 671-4155
Mailing address
522 S HUNT CLUB BLVD # 344, APOPKA, FL 32703-4960
(407) 297-9800
(407) 296-6272
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013593800
—
FL
Enumeration date
02/21/2017
Last updated
02/21/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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