# ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801568431
- **Authorized official:** DR. DANIEL A BLACK DPM (OWNER OF TIN/PRACTICE)
- **Authorized official phone:** (315) 382-5910

## Contact information

- **Practice address:** 113 NATURE WALK PWKY, STE. 105, SAINT AUGUSTINE, FL 32092
- **Practice address phone:** (315) 382-5910
- **Mailing address:** 230 MORNING MIST LN, SAINT JOHNS, FL 32259-8511
- **Mailing address phone:** (315) 382-5910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2021
- **Last updated:** 10/01/2021