| Entity Name: | THE FOOT & ANKLE INSTITUTE OF SOUTH FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Jan 1998 (27 years ago) |
| Document Number: | P98000009212 |
| FEI/EIN Number | 650809693 |
| Address: | 7000 SW 62 AVENUE, SUITE 405, MIAMI, FL, 33143, US |
| Mail Address: | 7000 SW 62 AVENUE, SUITE 405, MIAMI, FL, 33143, US |
| ZIP code: | 33143 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780638361 | 2006-05-19 | 2009-06-30 | 7000 SW 62ND AVE, SUITE 310, SOUTH MIAMI, FL, 331434716, US | 7000 SW 62ND AVE, SUITE 310, SOUTH MIAMI, FL, 331434716, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-662-1444 |
| Fax | 3056676086 |
| Fax | 3056752788 |
Authorized person
| Name | JASON R HANFT |
| Role | PRESIDENT |
| Phone | 3056621444 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO1940 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 45674 |
| State | FL |
| Issuer | MEDICARE RAILROAD |
| Number | 5630 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Rodriguez Manuel | Agent | 7000 SW 62 AVE, South Miami, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| Manuel Rodriguez R | President | 7000 SW 62 AVENUE SUITE 405, MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| Manuel Rodriguez R | Secretary | 7000 SW 62 AVENUE SUITE 405, MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| Manuel Rodriguez R | Treasurer | 7000 SW 62 AVENUE SUITE 405, MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| Manuel Rodriguez R | Director | 7000 SW 62 AVENUE SUITE 405, MIAMI, FL, 33143 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
