Provider Demographics
NPI:1528368727
Name:SCARLETT KINLEY D.P.M., P.A.
Entity Type:Organization
Organization Name:SCARLETT KINLEY D.P.M., P.A.
Other - Org Name:BAY AREA FOOT & ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCARLETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-441-8640
Mailing Address - Street 1:321 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5823
Mailing Address - Country:US
Mailing Address - Phone:727-441-8640
Mailing Address - Fax:727-441-8651
Practice Address - Street 1:321 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5823
Practice Address - Country:US
Practice Address - Phone:727-441-8640
Practice Address - Fax:727-441-8651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2265213E00000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40055OtherBCBS GROUP
FL65290OtherMEDICARE INDIVIDUAL
FL65290OtherBCBS INDIVIDUAL
FLDS4489OtherRR MEDICARE GROUP
FL390203000Medicaid
FLPO2265OtherMEDICAL LICENSE
FLP01031287OtherRR MEDICARE INDIVIDUAL
FL40055OtherBCBS GROUP
FL65290OtherBCBS INDIVIDUAL
FLU42358Medicare UPIN