Foot Care Store, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

PO1985 Issued in FL

Legal business name

FOOT CARE STORE, LLC

Doing business as

Diafoot

Practice address

3281 Fairlane Farms Rd Ste 4
Wellington, FL 33414-6503

Phone

(561) 791-1213

Fax

(561) 791-9919

NPI assigned

Jan 19, 2007

Last updated

Oct 8, 2026By 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

Robert M GaynorNPI 1205864105

Title

Director

Phone

(561) 721-7063

Specialties & licenses 2

Addresses

Other names 1

• DIAFOOT Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Foot Care Store, LLC

  dba Dia-Foot

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1568057057

  0941312177

  Same PAC ID

Tax ID family

Foot Care Store LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Footcare Store Inc

  dba DIA-Foot

  • Durable Medical Equipment & Medical Supplies
  • Lake Worth, FL
  • NPI 1225148018
  NPD tax ID
• Foot Care Store, LLC

  dba Dia-Foot

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1568057057
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Pacific Footwear Company, Inc.

  dba Priority Footwear & Pedorthic Services

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1558316851

  Member Of

  NPD member

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• HealthSun Health Plans Network
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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.

• Robert M Gaynor, DPM

  • Podiatrist
  • Wellington, FL
  • NPI 1205864105
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1740333061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3281 FAIRLANE FARMS RD STE 4",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146503",
            "telephone_number": "561-791-1213",
            "fax_number": "561-791-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3281 FAIRLANE FARMS RD STE 4",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146503",
            "telephone_number": "561-791-1213",
            "fax_number": "561-791-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT CARE STORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "GAYNOR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-721-7063"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PO1985",
            "primary": true
        },
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIAFOOT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DIAFOOT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Florida Woman Care, LLC
• Anyel D Fonseca I
• Jennifer Darlene Fonseca, ARNP
• Itchaqueira Beatriz Fontanez Vendrell, RD/LDN
• Foot Care Store Inc (Dia-Foot)
• Britney Foote, APRN
• Footsteps to Freedom Recovery
• Paulina Cecilia Ford
• Teaondra M Ford, ARNP
• Forgotten Mom, Inc.

• Durable Medical Equipment & Medical Supplies in Wellington, FL
• Providers in Wellington, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; 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.