Sunshine State Podiatry Llc | |
24830 Burnt Pine Dr Ste 3, Bonita Springs, FL 34134-1974 | |
(239) 703-9301 | |
Not Available |
Full Name | Sunshine State Podiatry Llc |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 24830 Burnt Pine Dr Ste 3, Bonita Springs, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700375458 | NPI | - | NPPES |
PO3990 | Other | FL | DEPARTMENT OF HEALTH |
PO3984 | Other | FL | DEPARTMENT OF HEALTH FLORIDA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | 3984 (Florida) | Primary |
Provider Name | Stephanie Ann Fields |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1417362013 PECOS PAC ID: 4082959341 Enrollment ID: I20181214002679 |
Provider Name | Konstantin Agarunov |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1194130211 PECOS PAC ID: 7719227081 Enrollment ID: I20190322002200 |
Mailing Address | Practice Location Address |
---|---|
Sunshine State Podiatry Llc 8353 Sw 124th St Ste 206, Miami, FL 33156-5847 Ph: (239) 703-9301 | Sunshine State Podiatry Llc 24830 Burnt Pine Dr Ste 3, Bonita Springs, FL 34134-1974 Ph: (239) 703-9301 |
Harry Cotler Inc. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 23421 Walden Center Dr., Ste. 100, Bonita Springs, FL 34134 Phone: 239-444-0700 Fax: 239-444-0900 | |
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