Organization
ST. AUGUSTINE FOOT & ANKLE, INC.
Active
Organization
ST. AUGUSTINE FOOT & ANKLE, INC.
Active
Parent organization
ST. AUGUSTINE FOOT & ANKLE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. AUGUSTINE FOOT & ANKLE, INC.
Authorized official
THOMAS LEBEAU DPM (OWNER)
(904) 824-0869
Entity
Organization
Contact information
Practice address
105 SOUTHPARK BLVD, STE A103, ST AUGUSTINE, FL 32086-5191
(904) 824-0869
Mailing address
2980 N BEVERLY GLEN CIR, STE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
04/08/2010
Last updated
10/27/2011
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