Organization
TIMOTHY C. RUNYON, D.P.M. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE C KINMON DPM (PROVIDER/OWNER)
(561) 995-0229
Entity
Organization
Contact information
Practice address
1401 16TH ST N, ST. PETERSBURG, FL 33704-4123
(727) 894-0794
(727) 895-1215
Mailing address
1401 16TH ST N, ST. PETERSBURG, FL 33704-4123
(727) 894-0794
(727) 895-1215
Taxonomy
Speciality
Code
Description
License number
State
213ER0200X
Radiology Podiatrist
PO1101
FL
213ES0000X
Sports Medicine Podiatrist
PO1101
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO1101
FL
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
PO1101
FL
332BC3200X
Customized Equipment (DME)
PO1101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340415300
—
FL
Enumeration date
01/22/2007
Last updated
10/09/2024
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