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General NPI Number Information
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NPI Number | 1295199172
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Entity Type | Organization
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Legal Business Name | COASTAL FOOT & ANKLE SPECIALISTS LLC
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 7035 1ST AVE S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-1203
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Country | US
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Telephone | 727-347-8872
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Fax | 727-343-6670
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Provider Business Mailing Address
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Address Line | 7035 1ST AVE S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-1203
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Country | US
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Telephone | 727-347-8872
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Fax | 727-343-6670
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER ZELNA
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Credential | DPM
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Telephone | 732-995-8572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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