Innovative Foot and Ankle Specialists PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

INNOVATIVE FOOT AND ANKLE SPECIALISTS PLLC

Practice address

3900 Lake Center Dr Ste A1
Mount Dora, FL 32757-2203

Phone

(352) 562-7590

Fax

(352) 663-8530

NPI assigned

Jul 4, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Allen Tootle, DPMNPI 1023468295

Title

Podiatrist, Provider

Phone

(352) 562-7590

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Kevin Allen Tootle, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Mount Dora, FL
  • NPI 1023468295
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1457197873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770754",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347770754",
            "telephone_number": "352-744-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LAKE CENTER DR STE A1",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572203",
            "telephone_number": "352-562-7590",
            "fax_number": "352-663-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE FOOT AND ANKLE SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-04",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "TOOTLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PODIATRIST, PROVIDER",
        "authorized_official_telephone_number": "352-562-7590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.