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Organization

PODIATRY ASSOCIATES OF FLORIDA INC

Active
Other names
Podiatry Associates of Northeast Florida Inc
Organization subpart
No

Provider details

NPI number
Authorized official
JEANNIE M BASKIN (CORPORATE ADMINISTRATOR)
(904) 224-2001
Entity
Organization

Contact information

Practice address
1824 BLANDING BLVD, JACKSONVILLE, FL 32210-1904
(904) 224-2001
(904) 224-2002
Mailing address
3117 SPRING GLEN RD, STE 402, JACKSONVILLE, FL 32207-5906
(904) 224-2001
(904) 224-2002

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480025470
RAILROAD MEDICARE
01
65047
BLUE CROSS BLUE SHIELD
01
CI4974
RAILROAD MEDICARE
01
CN7422
RAILROAD MEDICARE
01
DC3124
RAILROAD MEDICARE
Enumeration date
09/26/2006
Last updated
05/26/2017
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