Provider Demographics
NPI:1730367897
Name:SEBRING FOOTCARE PA
Entity type:Organization
Organization Name:SEBRING FOOTCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:P
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:863-382-3228
Mailing Address - Street 1:PO BOX 1719
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33871-1719
Mailing Address - Country:US
Mailing Address - Phone:863-382-3228
Mailing Address - Fax:863-382-8011
Practice Address - Street 1:206 W CENTER AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3106
Practice Address - Country:US
Practice Address - Phone:863-382-3228
Practice Address - Fax:863-382-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2173332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053807800Medicaid
FL053807800Medicaid
FLDP434AMedicare PIN