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) 224-2001
Entity
Organization
Contact information
Practice address
2140 KINGSLEY AVE STE 12, ORANGE PARK, FL 32073
(904) 224-2000
(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
—
480025510
RAILROAD MEDICARE
—
01
—
480025511
RAILROAD MEDICARE
—
01
—
480025512
RAILROAD MEDICARE
—
01
—
65238
BLUE CROSS BLUE SHIELD
—
01
—
65484
BLUE CROSS BLUE SHIELD
—
01
—
87303
BLUE CROSS BLUE SHIELD
—
01
—
CN7223
RAILROAD MEDICARE
—
01
—
P00603525
RAILROAD MEDICARE
—
Enumeration date
09/26/2006
Last updated
03/15/2019
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