1871037267 NPI number — PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM PA

Table of content: (NPI 1871037267)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871037267 NPI number — PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PASCARELLA, HOOVER, FINKELSTEIN & WAGNER, DPM PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FOOT AND ANKLE ASSOCIATES OF FLORIDA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871037267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
661 E ALTAMONTE DRIVE
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
ALTAMONTE SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-339-7759
Provider Business Mailing Address Fax Number:
407-915-5588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1307 S INTERNATIONAL PKWY
Provider Second Line Business Practice Location Address:
SUITE 1061
Provider Business Practice Location Address City Name:
LAKE MARY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32746-1413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-915-5587
Provider Business Practice Location Address Fax Number:
407-915-5588
Provider Enumeration Date:
12/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
PASCARELLA
Authorized Official First Name:
EUGENE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
407-339-7759

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1125200004 . This is a "MEDICARE NSC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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