Provider Demographics
NPI:1679939623
Name:FOOT AND ANKLE SPECIALISTS OF FLORIDA, LLC
Entity type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SELBST
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-806-0600
Mailing Address - Street 1:8500 EAGLE RUN DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5430
Mailing Address - Country:US
Mailing Address - Phone:561-806-0600
Mailing Address - Fax:561-501-0099
Practice Address - Street 1:16244 S MILITARY TRL STE 220
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6505
Practice Address - Country:US
Practice Address - Phone:561-806-0600
Practice Address - Fax:561-501-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty