Organization
ELITE FOOT & ANKLE SPECIALITSTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOB TIMENY DPM (OWNER)
(239) 689-5130
Entity
Organization
Contact information
Practice address
15740 NEW HAMPSHIRE CT, SUITE B, FORT MYERS, FL 33908-4173
(239) 689-5130
Mailing address
15740 NEW HAMPSHIRE CT, SUITE B, FORT MYERS, FL 33908-4173
(239) 689-5130
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3490
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004775300
—
FL
Enumeration date
11/28/2012
Last updated
11/28/2012
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