Provider Demographics
NPI:1831251743
Name:TOTAL FOOT CARE PA
Entity type:Organization
Organization Name:TOTAL FOOT CARE PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-899-1086
Mailing Address - Street 1:6711 38TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1536
Mailing Address - Country:US
Mailing Address - Phone:727-527-1249
Mailing Address - Fax:727-521-1240
Practice Address - Street 1:6711 38TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1536
Practice Address - Country:US
Practice Address - Phone:727-527-1249
Practice Address - Fax:727-521-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057899100Medicaid
FL057899100Medicaid
FLT50965Medicare UPIN
FL1076700001Medicare NSC