Organization
DUNNELLON PODIATRY CENTER P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY LYNN WITFILL DPM (OWNER PODIATRIST)
(352) 489-6621
Entity
Organization
Contact information
Practice address
11786 CEDAR STREET, DUNNELLON PODIATRY CENTER PA, DUNNELLON, FL 34431
(352) 489-6621
(352) 489-6920
Mailing address
PO BOX 2633, DUNNELLON PODIATRY CENTER PA, DUNNELLON, FL 34430
(352) 489-6621
(352) 489-6920
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P02759
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65619
BCBS
FL
Enumeration date
07/16/2006
Last updated
12/12/2007
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