Provider Demographics
NPI:1184757635
Name:FLORIDA COAST FOOT & ANKLE PA
Entity type:Organization
Organization Name:FLORIDA COAST FOOT & ANKLE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ABADY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-384-3338
Mailing Address - Street 1:1001 37TH STREET NORTH
Mailing Address - Street 2:SUITE F
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6010
Mailing Address - Country:US
Mailing Address - Phone:727-384-3338
Mailing Address - Fax:727-347-3668
Practice Address - Street 1:1001 37TH STREET NORTH
Practice Address - Street 2:SUITE F
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6010
Practice Address - Country:US
Practice Address - Phone:727-384-3338
Practice Address - Fax:727-347-3668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3206213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003164800Medicaid
FL003164800Medicaid
FLAB905Medicare PIN
FLU79349Medicare UPIN