Individual
MARY C RELLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2308 GREESIDE COURT, PONTE VEDRA BEACH, FL 32082-3700
(904) 373-0981
(904) 373-0981
Mailing address
2308 GREENSIDE CT, PONTE VEDRA BEACH, FL 32082-3700
(904) 373-0981
(904) 373-0981
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2236
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059783000
—
FL
01
—
65224
BCBS
FL
Enumeration date
03/14/2007
Last updated
01/23/2017
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