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Individual

DR. WASSEM E FARAGALLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
13600 ICOT BLVD, BLDG. B, CLEARWATER, FL 33760-3703
(888) 290-6321
(727) 669-8417
Mailing address
11416 GRAMERCY PARK AVE, BRADENTON, FL 34211-8459

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3803
FL
213ES0131X
Foot Surgery Podiatrist
Primary
PO3803
FL

Other

Enumeration date
06/07/2013
Last updated
03/22/2018
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