Healthcare Provider Details

I. General information

NPI: 1710399555
Provider Name (Legal Business Name): ALL ABOUT FEET & LEGS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SAINT JOHNS MEDICAL PARK DR
ST AUGUSTINE FL
32086-5298
US

IV. Provider business mailing address

6 SAINT JOHNS MEDICAL PARK DR
ST AUGUSTINE FL
32086-5298
US

V. Phone/Fax

Practice location:
  • Phone: 904-823-3301
  • Fax: 904-823-3328
Mailing address:
  • Phone: 904-823-3301
  • Fax: 904-823-3328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSANA RODRIGUEZ
Title or Position: PHYSICIAN
Credential: DPM
Phone: 904-823-3301