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Organization
BAYSHORE PODIATRY CENTER
Active
Organization
BAYSHORE PODIATRY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES EDWARD REPKO DPM (PRESIDENT)
(813) 877-6636
Entity
Organization
Contact information
Practice address
508 S HABANA AVE STE 230, TAMPA, FL 33609-4161
(813) 877-6636
(813) 877-6610
Mailing address
508 S HABANA AVE STE 230, TAMPA, FL 33609-4161
(813) 877-6636
(813) 877-6610
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
P00001221
FL
213ES0000X
Sports Medicine Podiatrist
Primary
—
FL
261QP1100X
Podiatric Clinic/Center
—
NULL
Other
Enumeration date
11/30/2005
Last updated
10/23/2024
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