Contract Details
Ancillary Care Services
Facility name
Podiatry Foot & Ankle Surgical Group of South Florida
Provider ID
P000005856
Tax ID
650203614
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
601 North Flamingo Road Suite 101
Pembroke Pines, FL 33028
United States
County
Broward
Phone
9544354949 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address