Organization
BARE FOOT CARE SPECIALIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNETTE VELAZQUEZ DPM (OWNER)
(770) 531-9222
Entity
Organization
Contact information
Practice address
3485 ATLANTA HWY, FLOWERY BRANCH, GA 30542-2918
(770) 531-9222
Mailing address
3485 ATLANTA HWY, FLOWERY BRANCH, GA 30542-2918
(770) 531-9222
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD 1075
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2771997
UHC
GA
01
—
4384641
CIGNA
GA
01
—
511G700542
MEDICARE PART B
GA
01
—
52222642-004
BCBS
GA
05
—
576003162B
—
GA
01
—
7861901
AETNA
GA
Enumeration date
05/30/2008
Last updated
01/23/2009
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