DPM HAIRSTON 01 FL LLC NPI 1508988015

NPI Information

  • NPI: 1508988015
  • Provider Name: DPM HAIRSTON 01 FL LLC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 12900 CORTEZ BLVD STE 102
    BROOKSVILLE, FL
    ZIP 34613
  • Phone: (352) 683-6618

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NPI Details

DPM HAIRSTON 01 FL LLC is a foot and ankle surgery podiatrist in Brooksville, FL. DPM HAIRSTON 01 FL LLC NPI is 1508988015. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12900 CORTEZ BLVD STE 102
BROOKSVILLE, FL
ZIP 34613-897
Phone: (352) 683-6618
Fax: (352) 683-5722

The provider's authorized official is Earlie Owens Hairston .
The authorized official title is Owner and has the following contact phone number (352) 683-6618.

The enumeration date for this NPI number is 4/4/2007 and was last updated on 1/30/2025.

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
1213ES0103XPodiatristFoot & Ankle SurgeryK7562FLORIDAYes

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
1340486200MEDICAIDFLORIDA

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: 11/21/2025

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