Organization
BAYSHORE PODIATRY CENTER INC
Active
Other names
Bayshore Podiatry Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES EDWARD REPKO DPM (PRESIDENT)
(813) 877-6636
Entity
Organization
Contact information
Practice address
508 S HABANA AVE, 230, TAMPA, FL 33609-4181
(813) 877-6636
(813) 877-6636
Mailing address
508 S HABANA AVE, SUITE 230, TAMPA, FL 33609-4181
(813) 877-6636
(813) 877-6610
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
P02913
FL
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029670800
—
FL
Enumeration date
11/28/2005
Last updated
10/23/2024
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