Provider Demographics
NPI:1194772863
Name:ADVANCED FOOT AND ANKLE CARE, INC.
Entity type:Organization
Organization Name:ADVANCED FOOT AND ANKLE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JULIET
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:941-921-3000
Mailing Address - Street 1:4801 SWIFT RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5139
Mailing Address - Country:US
Mailing Address - Phone:941-921-3000
Mailing Address - Fax:941-921-3066
Practice Address - Street 1:4801 SWIFT RD
Practice Address - Street 2:SUITE F
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5139
Practice Address - Country:US
Practice Address - Phone:941-921-3000
Practice Address - Fax:941-921-3066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340484600Medicaid
FL97703OtherBCBS
FL340476500Medicaid
FL340476500Medicaid
FLDE8293Medicare PIN
FL97703OtherBCBS