Healthcare Provider Details

I. General information

NPI: 1568518108
Provider Name (Legal Business Name): CINDYLEE CALALUCA'S FORGOTTEN COAST PODIATRY & HAPPY FEET BOUTIQUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 COASTAL HIGHWAY
PANACEA FL
32346
US

IV. Provider business mailing address

1329 COASTAL HIGHWAY P.O. BOX 646
PANACEA FL
32346
US

V. Phone/Fax

Practice location:
  • Phone: 850-984-0090
  • Fax: 850-984-8156
Mailing address:
  • Phone: 850-984-0090
  • Fax: 850-984-8156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO1973
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP2185832
License Number StateFL

VIII. Authorized Official

Name: MRS. CINDYLEE CALALUCA
Title or Position: OWNER
Credential: ARNP
Phone: 850-984-0090