Advance Tampa Bay Foot Medical, LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO2234 Issued in FL

Legal business name

ADVANCE TAMPA BAY FOOT MEDICAL, LLC

Practice address

3325 W Gandy Blvd
Tampa, FL 33611-2931

Phone

(813) 831-3813

NPI assigned

Oct 9, 2012

Last updated

May 11, 2017By 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

Dr. Benjamin Q Le, DPMNPI 1386743383

Title

Authorize Officer

Phone

(813) 831-3813

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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.

• Benjamin Quang Le, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
  • NPI 1386743383
  Medicare reassignment NPD Authorized official
• Marilyn L Le, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
  • NPI 1508965591
  NPD (past)

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1821340225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13485",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336813485",
            "telephone_number": "813-831-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112931",
            "telephone_number": "813-831-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE TAMPA BAY FOOT MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "AUTHORIZE OFFICER",
        "authorized_official_telephone_number": "813-831-3813",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO2234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007286100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot Surgery Podiatrist in Tampa, FL
• Providers in Tampa, 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 May 11, 2017; 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.