Provider Demographics
NPI:1679326441
Name:ADVANCED FOOT AND ANKLE CENTERS INC
Entity type:Organization
Organization Name:ADVANCED FOOT AND ANKLE CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-239-3713
Mailing Address - Street 1:6707 38TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1536
Mailing Address - Country:US
Mailing Address - Phone:727-800-9958
Mailing Address - Fax:
Practice Address - Street 1:2131 HERNDON AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6304
Practice Address - Country:US
Practice Address - Phone:727-239-3713
Practice Address - Fax:855-552-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty