| NPI | 1053968149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MEDINA OAKLEY Owner 305-930-7934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 261QP1100X Clinic/Center, Podiatric | |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2022-08-11 |