Organization
SON SHINE FOOT AND ANKLE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT ANDREW DERRICO DPM (PHYSICIAN)
(772) 380-0900
Entity
Organization
Contact information
Practice address
1405 SE GOLDTREE DR, SUITE B, PORT ST LUCIE, FL 34952-7563
(772) 380-0900
(772) 380-0901
Mailing address
PO BOX 8210, PORT ST LUCIE, FL 34985-8210
(772) 380-0900
(772) 380-0901
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2649
FL
Other
Enumeration date
06/01/2006
Last updated
01/03/2008
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