Organization
FOOT AND ANKLE SPORT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTINE A. BOLLO DPM (OWNER)
(954) 450-0099
Entity
Organization
Contact information
Practice address
17751 SW 2ND ST, PEMBROKE PINES, FL 33029-3924
(954) 450-0099
(866) 381-9207
Mailing address
17751 SW 2ND ST, PEMBROKE PINES, FL 33029-3924
(954) 450-0099
(866) 381-9207
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2570
FL
Other
Enumeration date
11/23/2010
Last updated
09/16/2016
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