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Organization

ACTIVE FOOT CARE, INC.

Active
Parent organization
ACTIVE FOOT CARE
Other names
Jalal K Sidani DPM
Organization subpart
Yes

Provider details

NPI number
Legal business name
ACTIVE FOOT CARE
Authorized official
DR. JALAL K SIDANI DPM (PODIATRIST)
(850) 769-1055
Entity
Organization

Contact information

Practice address
2563 HUNTCLIFF LANE, PANAMA CITY, FL 32405-4902
(850) 769-1055
(850) 769-1434
Mailing address
2563 HUNTCLIFF LANE, PANAMA CITY, FL 32405-4902
(850) 769-1055
(850) 769-1434

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P02326
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
390159900
FL
Enumeration date
04/11/2008
Last updated
03/07/2013
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