Provider Demographics
NPI:1649326802
Name:KINLEY, SCARLETT A (DPM)
Entity type:Individual
Prefix:DR
First Name:SCARLETT
Middle Name:A
Last Name:KINLEY
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2025-03-11
Deactivation Date:2025-02-07
Deactivation Code:
Reactivation Date:2025-03-11
Provider Licenses
StateLicense IDTaxonomies
FLPO 2265213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65290OtherBCBS INDIVIDUAL
FLPO2265OtherMEDICAL LICENSE
FLP01031287OtherRR MEDICARE INDIVIDUAL
FL390203000Medicaid
FL65290OtherMEDICARE INDIVIDUAL
FLPO2265OtherMEDICAL LICENSE
FL65290OtherMEDICARE INDIVIDUAL