| Coastal Foot & Ankle Wellness Center Llc | |
|
1740 Tree Blvd Ste 112, St Augustine, FL 32084-5720 | |
| (904) 826-1900 | |
| (904) 826-1920 |
| Full Name | Coastal Foot & Ankle Wellness Center Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 1740 Tree Blvd Ste 112, St Augustine, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972834760 | NPI | - | NPPES |
| 000NU | Other | FL | BCBS OF FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | P02829 (Florida) | Primary |
| Provider Name | Jose Concha |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992742142 PECOS PAC ID: 5799820213 Enrollment ID: I20100320000263 |
| Provider Name | Richard W Johnson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1477590248 PECOS PAC ID: 1254476773 Enrollment ID: I20100320000279 |
| Provider Name | Roman Ivankiv |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528517331 PECOS PAC ID: 4880946235 Enrollment ID: I20210409001826 |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Foot & Ankle Wellness Center Llc 1740 Tree Blvd Ste 112, St Augustine, FL 32084-5720 Ph: (904) 826-1900 | Coastal Foot & Ankle Wellness Center Llc 1740 Tree Blvd Ste 112, St Augustine, FL 32084-5720 Ph: (904) 826-1900 |
Ryan J Pereira, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1301 Plantation Island Dr S, Ste 203, St Augustine, FL 32080 Phone: 904-461-0821 Fax: 904-461-0823 | |
Ankle & Foot Associates Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 309 Kingsley Lake Dr, # 901, St Augustine, FL 32092 Phone: 904-269-9595 Fax: 904-264-5211 | |
Dr. Nicole C Gortaire, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1690 Us Highway 1 S Ste C, St Augustine, FL 32084 Phone: 904-436-8001 Fax: 904-376-7761 | |
Victoria Jean Camp, DPM, PA Podiatrist Medicare: Medicare Enrolled Practice Location: 1093 A1a Beach Blvd, Pmb 235, St Augustine, FL 32080 Phone: 904-814-4904 | |
Brett Cutler Dpm Pa Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 105 Southpark Blvd, Suite A103, St Augustine, FL 32086 Phone: 904-824-0869 Fax: 904-826-0966 | |
Dr. John M Burns, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1975 Old Moultrie Rd, St Augustine, FL 32086 Phone: 904-825-0046 Fax: 904-826-1586 | |
Meleca Foot And Ankle Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 432 Paseo Reyes Dr, St Augustine, FL 32095 Phone: 517-990-7844 |