Provider Demographics
NPI:1174910285
Name:CMP FOOT & ANKLE LLC
Entity type:Organization
Organization Name:CMP FOOT & ANKLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANTEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PINNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:904-338-8458
Mailing Address - Street 1:222 NE 25TH ST
Mailing Address - Street 2:APT 1104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6175 NW 153RD ST
Practice Address - Street 2:STE 212
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2435
Practice Address - Country:US
Practice Address - Phone:904-338-8458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty