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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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