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ST PETERSBURG DIABETIC & ARTHRITIC FOOT CENTER PA NPI 1356625297


NPI Information

NPI: 1356625297
Provider Name: ST PETERSBURG DIABETIC & ARTHRITIC FOOT CENTER PA
Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
4200 CENTRAL AVE
ST PETERSBURG, FL
ZIP 33711
Phone: (727) 321-8806
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ST PETERSBURG DIABETIC & ARTHRITIC FOOT CENTER PA is a podiatric clinic center in St Petersburg, FL. ST PETERSBURG DIABETIC & ARTHRITIC FOOT CENTER PA NPI is 1356625297. The provider is registered as an organization entity type.

The provider's business location address is:

4200 CENTRAL AVE
ST PETERSBURG, FL
ZIP 33711-140
Phone: (727) 321-8806
Fax: (727) 321-6838

The provider's authorized official is Darall J Moore .
The authorized official title is President/podiatrist and has the following contact phone number (727) 321-8806.

The enumeration date for this NPI number is 10/10/2011 and was last updated on 9/30/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP1100XClinic/CenterPodiatricYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15192590001MEDICARE NSCFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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