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General NPI Number Information
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NPI Number | 1194130211
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Entity Type | Individual
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Provider Name | KONSTANTIN AGARUNOV D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 6707 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1536
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Country | US
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Telephone | 727-896-4615
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Fax | 727-256-3855
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Provider Business Mailing Address
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Address Line | 8353 SW 124TH ST STE 206
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City | MIAMI
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State | FL
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Zip | 33156-5847
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Country | US
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Telephone | 718-664-7482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3990
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License Number State | FL
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