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Organization

GERARDO PEREZ-ESPINDOLA

Active
Other names
Podomedik Clinics
Organization subpart
No

Provider details

NPI number
Authorized official
GERARDO PEREZ-ESPINDOLA DPM (OWNER/PHYSICIAN)
(847) 249-3888
Entity
Organization

Contact information

Practice address
425 SHORELAND DR, RACINE, WI 53402-3829
(856) 520-4513
Mailing address
425 SHORELAND DR, RACINE, WI 53402-3829
(856) 520-4513

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-005265
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000082037
MEDICARE PTAN
WI
01
000082039
MEDICARE PTAN
WI
01
215839
MEDICARE PTAN
IL
Enumeration date
01/08/2009
Last updated
01/08/2009
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