Organization
ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL A BLACK DPM (OWNER OF TIN/PRACTICE)
(315) 382-5910
Entity
Organization
Contact information
Practice address
113 NATURE WALK PWKY, STE. 105, SAINT AUGUSTINE, FL 32092
(315) 382-5910
Mailing address
230 MORNING MIST LN, SAINT JOHNS, FL 32259-8511
(315) 382-5910
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
10/01/2021
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