Organization
HEALTH PARK FOOT & ANKLE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED W MALLARD (OWNER)
(904) 825-0046
Entity
Organization
Contact information
Practice address
1975 OLD MOULTRIE RD, ST AUGUSTINE, FL 32086-5164
(904) 825-0046
(904) 826-1586
Mailing address
1975 OLD MOULTRIE RD, ST AUGUSTINE, FL 32086-5164
(904) 825-0046
(904) 826-1586
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340409900
—
FL
Enumeration date
07/02/2006
Last updated
01/26/2010
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