Organization
DIRECT FOOT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BITA ANSARI DPM (MANAGER)
(813) 541-8734
Entity
Organization
Contact information
Practice address
5535 MEMORIAL HWY, TAMPA, FL 33634-7332
(813) 574-4869
Mailing address
121 HICKORY CREEK DR, BRANDON, FL 33511-8059
(813) 541-8734
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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