Organization
PODIATRY ASSOCIATES OF FLORIDA INC
Active
Other names
Podiatry Associates of Northeast Florida Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE M BASKIN (CORPORATE ADMINISTRATOR)
(904) 251-5053
Entity
Organization
Contact information
Practice address
1914 SOUTHSIDE BLVD, STE 1, JACKSONVILLE, FL 32216-1930
(904) 224-2001
(904) 224-2002
Mailing address
2140 KINGSLEY AVE STE 12, ORANGE PARK, FL 32073-5129
(904) 224-2001
(904) 224-2002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480025754
RAILROAD MEDICARE
—
01
—
CI4974
RAILROAD MEDICARE
—
01
—
DA0704
RAILROAD MEDICARE
—
01
—
P00008626
RAILROAD MEDICARE
—
Enumeration date
10/18/2006
Last updated
06/07/2021
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