Organization
FARAGALLA FOOT CARE LLC
Active
Organization
FARAGALLA FOOT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WASSEM FARAGALLA (DPM)
(551) 655-4146
Entity
Organization
Contact information
Practice address
2105 MANATEE AVE E, BRADENTON, FL 34208-1640
(551) 655-4146
Mailing address
11416 GRAMERCY PARK AVE, BRADENTON, FL 34211-8459
(551) 655-4146
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
PO3803
FL
Other
Enumeration date
03/13/2017
Last updated
03/20/2018
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