Individual provider · Type 1 NPI
Roman Ivankiv
Foot Surgery Podiatrist · St. Augustine, FL
NPI number
1528517331
Active
Practice location
1740 Tree Blvd Ste 112
St. Augustine, FL 32084-5720
Fax (904) 826-1920
Other practice locations
- 204 Luds Way, Dothan, AL 36303-6350 · (334) 678-7036
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 338 (AL) |
| Foot Surgery Podiatrist Primary | 213ES0131X | PO4215 (FL) |
Foot Surgery Podiatrist: Definition to come...
Another provider at this address
Other foot surgery podiatrist providers in St. Augustine
About NPI 1528517331
Roman Ivankiv's National Provider Identifier is 1528517331, issued on Sep 22, 2016. The primary taxonomy on file is Foot Surgery Podiatrist (213ES0131X), and the practice location is in St. Augustine, FL. The record was last updated on Mar 28, 2021.