DAYTONA FOOT & ANKLE SPECIALISTS PA


Address: 311 N Clyde Morris Blvd, Suite 300, Daytona Beach, FL 32114-2756
Phone: 3862529656

DAYTONA FOOT & ANKLE SPECIALISTS PA (NPI# 1356521140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356521140
Entity Type Organization
Organization Name DAYTONA FOOT & ANKLE SPECIALISTS PA
Practice Address 311 N Clyde Morris Blvd
Suite 300
Daytona Beach
FL 32114-2756
Practice Telephone 3862529656
Practice Fax Number 3862524649
Mailing Telephone 3862529656
Mailing Fax Number 3862524649
Enumeration Date 2007-11-08
Last Update Date 2010-09-24
Authorized Official Name DR. ERIC MARK GOLDENBERG (PRESIDENT)
Authorized Official Telephone 3862529656
Authorized Official Credential D.P.M.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
PO2530 FL Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 340118900 05
FL BLUE CROSS BLUE SHIELD 65673 01

Office Location

Street Address 311 N CLYDE MORRIS BLVD
SUITE 300
City DAYTONA BEACH
State FL
Zip Code 32114-2756

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215933056 Gary A Wilson Surgery 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 2005-06-27
1699144436 Diane Santopadre Nurse Practitioner 311 N Clyde Morris Blvd, Suite 420, Daytona Beach, FL 32114-2781 2015-09-23
1104207281 Patricia Gonzalez Nurse Anesthetist, Certified Registered 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 2015-06-14
1881001162 Kimberly W Stackpole Physician Assistant 311 N Clyde Morris Blvd, Suite 320, Daytona Beach, FL 32114-2781 2014-07-17
1871918110 Jennifer Battani Nurse Anesthetist, Certified Registered 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 2014-02-24
1609111855 Digon Diabetes and Endocrinology, P.a. Internal Medicine 311 N Clyde Morris Blvd, Suite 440, Daytona Beach, FL 32114-2781 2012-11-29
1063719672 Kimberly Kay Koevenig Dietitian, Registered 311 N Clyde Morris Blvd, Suite 440-outpatient Diabetes Education, Halifax Health, Daytona Beach, FL 32114-2781 2011-02-16
1376871467 January Y Eudy Nurse Anesthetist, Certified Registered 311 N Clyde Morris Blvd, Ste 350, Daytona Beach, FL 32114-2781 2009-12-01
1538325238 Medical Arts Optical Service,inc Eyewear Supplier (Equipment, not the service) 311 N Clyde Morris Blvd, Suite 40, Daytona Beach, FL 32114-2781 2008-08-01
1508036419 Eric Stephen Piazza Physician Assistant 311 N Clyde Morris Blvd, Suite 580, Daytona Beach, FL 32114-2781 2008-03-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1376161380 Evolution Health & Performance LLC Physician Assistant 244 S. Palmetto Ave, Daytona Beach, FL 32114 2020-07-07
1407480189 Kierra Imani Kinsey Behavior Technician 1128-a Beville Rd, Daytona Beach, FL 32114 2020-03-02
1043776057 Outreach Community Care Network Inc Pharmacy 240 N. Frederick Avenue, Daytona Beach, FL 32114 2019-02-14
1033681861 Katherine Proppe Specialist/Technologist 1 Aerospace Blvd, Daytona Beach, FL 32114 2018-12-18
1841765047 Anna L Smith Nurse Practitioner 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 2018-10-04
1154806933 Steve Anthony Lee Family Medicine 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 2018-09-27
1285116491 Walgreen Co Durable Medical Equipment & Medical Supplies 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 2018-09-04
1770085656 Merina Lee Occupational Therapist 1159 Australia Ave., Daytona Beach, FL 32114 2018-03-06
1346752755 Hand & Upper Extremity Surgery of Daytona Beach, LLC Non-Pharmacy Dispensing Site 1241 Ridgewood Ave, Daytona Beach, FL 32114 2017-10-26
1104347053 Harry Herman Blanke IIi Family Medicine 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 2017-06-30
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Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1083901995 Laura Michelle Walton Podiatrist 1890 Lpga Blvd Suite 230, Daytona Beach, FL 32117 2011-06-30
1760092118 Upperline Healthcare, PC Podiatrist 1890 Lpga Blvd Ste 230, Daytona Beach, FL 32117-7131 2020-07-31
1629422118 John Michael Borzok Jr. Podiatrist 1890 Lpga Blvd Ste 230, Daytona Beach, FL 32117-7131 2016-04-20
1063874584 Joseph Thomas Watson Podiatrist 1890 Lpga Blvd Ste 230, Daytona Beach, FL 32117-7131 2016-03-23
1306288584 Zachery Philip Barnett Podiatrist 1890 Lpga Blvd Ste 230, Daytona Beach, FL 32117-7131 2013-07-29
1447412416 Hilaree Brooke Milliron Podiatrist 1890 Lpga Blvd, Suite 230, Daytona Beach, FL 32117-7130 2008-06-30
1689865453 Dennis Bruce Mcbroom Jr. Podiatrist 1890 Lpga Blvd, Suite 230, Daytona Beach, FL 32117-7130 2007-08-07
1134141617 James W Rust Podiatrist 1890 Lpga Blvd, Suite 230, Daytona Beach, FL 32117-7130 2006-07-24
1598787988 Andrew B Green Podiatrist 1890 Lpga Blvd, Suite 230, Daytona Beach, FL 32117-7130 2006-07-24
1154349082 Atlantic Podiatry Associates Dpm Pa Podiatrist 1890 Lpga Blvd, Ste 230, Daytona Beach, FL 32117-7131 2006-07-18
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Competitor

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City DAYTONA BEACH
Zip Code 32114

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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