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General NPI Number Information
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NPI Number | 1972797199
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Entity Type | Organization
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Legal Business Name | ALL FLORIDA PODIATRY, P.A.
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 5101 BRITTANY DR S
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City | ST PETERSBURG
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State | FL
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Zip | 33715-1565
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Country | US
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Telephone | 727-384-1111
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Fax | 727-384-1112
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Provider Business Mailing Address
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Address Line | 5760 10TH AVENUE NORTH
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City | ST. PETERSBURG
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State | FL
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Zip | 33710-6432
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Country | US
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Telephone | 727-384-1111
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Fax | 727-384-1112
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MRS. KIMBERLEE MARIE COLALUCE
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Credential |
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Telephone | 727-384-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO2815
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License Number State | FL
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