NPIMap

Organization Active NPI

Foot, Ankle & Leg Specialists

  • Non-Pharmacy Dispensing Site
  • Pembroke Pines, FL
National Provider Identifier
1124201991
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
PO02570 Issued in FL
Legal business name
FOOT, ANKLE & LEG SPECIALISTS
Practice address
17842 NW 2ND Street
Pembroke Pines, FL 33029
Phone
(954) 389-5900
NPI assigned
Dec 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Augustine BolloNPI 1134191588
Title
Physician
Phone
(954) 389-5900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X PO02570 FL Primary

Addresses

Primary practice location

17842 NW 2ND Street
Pembroke Pines, FL 33029

Mailing address

3607 Old Conejo Rd
Thousand Oaks, CA 91320-2123

National Provider Directory

National Provider Directory
Tax ID family
Foot Ankle Leg Specialists4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3607 Old Conejo Rd
Thousand Oaks, CA 91320
Phone (800) 787-7824

17842 NW 2nd St
Pembroke Pines, FL 33029
Phone (954) 367-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1124201991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 OLD CONEJO RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17842 NW 2ND STREET",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33029",
            "telephone_number": "954-389-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT, ANKLE & LEG SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "BOLLO",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "954-389-5900"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "PO02570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.