Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO 2285 | FL |
N | 222Z00000X | Podiatrist | PO 2285 | FL |
Y | 213ES0131X | Foot Surgery | PO 2285 | FL |
NPI | 1003864042 |
---|---|
Provider Name | Dr. Anthony J Emelianchik |
First Address | Eustis, FL 32726-6141 |
Second Address | Eustis, FL 32726-6141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 16/09/2008 |