# BAYSHORE PODIATRY CENTER

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

## Provider details

- **NPI number:** 1982688354
- **Authorized official:** DR. JAMES EDWARD REPKO DPM (PRESIDENT)
- **Authorized official phone:** (813) 877-6636

## Contact information

- **Practice address:** 508 S HABANA AVE STE 230, TAMPA, FL 33609-4161
- **Practice address phone:** (813) 877-6636
- **Practice address fax:** (813) 877-6610
- **Mailing address:** 508 S HABANA AVE STE 230, TAMPA, FL 33609-4161
- **Mailing address phone:** (813) 877-6636
- **Mailing address fax:** (813) 877-6610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | P00001221 | FL | — |
| 213ES0000X | Sports Medicine Podiatrist | — | FL | Yes |
| 261QP1100X | Podiatric Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/30/2005
- **Last updated:** 10/23/2024