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) 251-5053
Entity
Organization
Contact information
Practice address
2140 KINGSLEY AVE, STE 12, ORANGE PARK, FL 32073-5180
(904) 272-7070
(904) 272-3668
Mailing address
5911 TIMUQUANA RD UNIT 300, JACKSONVILLE, FL 32210-7897
(904) 251-5053
(904) 224-2002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390364800
—
FL
01
—
480026736
RAILROAD MEDICARE
—
01
—
480030919
RAILROAD MEDICARE
—
01
—
65490
BLUE CROSS BLUE SHIELD
—
01
—
87629
BLUE CROSS BLUE SHIELD
—
01
—
CI4974
MEDICARE
FL
01
—
P00442507
RAILROAD MEDICARE
—
Enumeration date
09/26/2006
Last updated
10/05/2021
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