Individual
MARC GREGORY COLALUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5760 10TH AVE N, ST PETERSBURG, FL 33710-6432
(727) 384-1111
(727) 384-1112
Mailing address
5760 10TH AVE N, ST PETERSBURG, FL 33710-6432
(727) 384-1111
(727) 384-1112
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2815
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11010101
CITRUSCAID
FL
01
—
11187
AMERIGROUP
FL
01
—
163508
STAYWELL
FL
01
—
1734395
FIRST HEALTH
FL
01
—
21212024000
BEECHSTREET
FL
01
—
2700633
UNITED
FL
01
—
59368468133733A01
TRICARE STANDARD PPO
FL
01
—
649524
TUFTS
FL
01
—
65644
BCBS
FL
Enumeration date
05/25/2007
Last updated
02/18/2008
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