Jla Senior Footcare Fla LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO 3438 Issued in FL

Legal business name

JLA SENIOR FOOTCARE FLA LLC

Practice address

425 N Peninsula Dr Ste a
Daytona Beach, FL 32118-4082

Phone

(386) 252-4678

NPI assigned

Aug 31, 2010

Last updated

Aug 31, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anthony Innocenzi, DPMNPI 1255336079

Title

Owner

Phone

(330) 702-0978

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Innocenzi, DPM

  • Podiatrist
  • Canfield, OH
  • NPI 1255336079
  Authorized official Same address or phone

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1477869204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 S ASPEN CT",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N PENINSULA DR STE A",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184082",
            "telephone_number": "386-252-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLA SENIOR FOOTCARE FLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "INNOCENZI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-702-0978",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO 3438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeannie Jenuwine
• D. Michael Jervis, DO
• Alison Marie Jimenez
• Irisdane Jimenez, MSW
• Jessica Sarah Jimenez, PA-C
• Gary Johanson, LDO
• John Anthony White,M.D.,P.a.
• John Arthur Anderson, P.a. (Daytona Denture Center)
• John Assi, MD, PA (Children's Health Associtates)
• John Assi, MD, PA (Children's Health Associates)

• Foot Surgery Podiatrist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Foot Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.