Provider Demographics
NPI:1720230485
Name:FAMILY FOOT & ANKLE OF STUART PL
Entity type:Organization
Organization Name:FAMILY FOOT & ANKLE OF STUART PL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHOPPE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:772-221-1193
Mailing Address - Street 1:2220 SE OCEAN BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3308
Mailing Address - Country:US
Mailing Address - Phone:772-221-1193
Mailing Address - Fax:772-221-1152
Practice Address - Street 1:2220 SE OCEAN BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3308
Practice Address - Country:US
Practice Address - Phone:772-221-1193
Practice Address - Fax:772-221-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2822213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU75967Medicare UPIN
FL6217750001Medicare NSC