Organization
PODIATRY ASSOCIATES OF FLORIDA INC
Active
Other names
Podiatry Associates of Northeast Florida Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN G SINCHUK (BUSINESS ADMINISTRATOR)
(904) 224-2001
Entity
Organization
Contact information
Practice address
220 SOUTHPARK CIR E, ST AUGUSTINE, FL 32086-5135
(904) 829-2855
(904) 829-0672
Mailing address
3117 SPRING GLEN RD, STE 402, JACKSONVILLE, FL 32207-5906
(904) 224-2001
(904) 224-2002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
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
09/20/2007
Last updated
09/03/2009
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