Organization
LIGHTHOUSE FOOT & ANKLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLETTE TARA D'ALTILIO D.P.M. (MANAGEING MEMBER)
(954) 933-9033
Entity
Organization
Contact information
Practice address
2100 NE 36TH ST, SUITE 203, LIGHTHOUSE PT, FL 33064-7574
(954) 933-9033
(954) 934-0060
Mailing address
PO BOX 50163, LIGHTHOUSE PT, FL 33074-0163
(954) 933-9033
(954) 934-0060
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3030
FL
Other
Enumeration date
07/27/2007
Last updated
07/22/2009
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