Organization
PREMIER FOOT AND ANKLE SPECIALISTS PA
Active
Other names
Premier Foot and Ankle Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BAYLINSON (CONSULTANT)
(856) 873-6065
Entity
Organization
Contact information
Practice address
4120 WOODMERE PARK BLVD STE 5, VENICE, FL 34293-5373
(941) 488-0222
(941) 480-1668
Mailing address
4120 WOODMERE PARK BLVD STE 5, VENICE, FL 34293-5373
(941) 488-0222
(941) 480-1668
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO-1580
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041248100
—
FL
01
—
74640
GROUP BCBS
FL
Enumeration date
08/04/2006
Last updated
04/05/2021
Update your record
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