Organization
GENTLE FOOT CARE CLINIC, PA
Active
Parent organization
GENTLE FOOT CARE CLINIC, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENTLE FOOT CARE CLINIC, PA
Authorized official
JAIRO B CRUZ DPM (MEDICAL DIRECTOR)
(813) 782-3233
Entity
Organization
Contact information
Practice address
601 LITHIA PINECREST RD, BRANDON, FL 33511-6114
(813) 782-3233
(813) 502-5904
Mailing address
601 LITHIA PINECREST RD, BRANDON, FL 33511-6114
(813) 782-3233
(813) 502-5904
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5157370001
DME
FL
Enumeration date
01/30/2023
Last updated
01/30/2023
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