SIWICKI & RICCIARDI,P.L.
Podiatry at Mar Walt Dr, Fort Walton Beach, FL

License number
Florida PO1110 & PO2964
Category
Podiatry
Type
Podiatrist
Owner
Name: DR. COSIMO A RICCIARDI D.P.M.
Title: CEO
Phone: (850) 862-4119
Address
Address
914A Mar Walt Dr, Fort Walton Beach, FL 32547
National Provider ID: 1265472211
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Siwicki & Ricciardi PL - Cosimo Ricciardi DPM

341 Racetrack Rd NW, Ft Walton Beach, FL 32547

Categories:
Podiatry Physicians & Surgeons
Phone:
(850) 862-4119 (Phone)

SIWICKI & RICCIARDI, P.L

Ft Walton Beach, FL

Status:
Inactive
Industry:
Podiatrist's Office
Inactive reason:
Lc Amendment
Registration:
Feb 16, 2006
Inactive since:
Mar 6, 2006
Addresses:
341 Racetrack Rd SUITE A, Ft Walton Beach, FL 32547 (Physical)
914A Mar Walt Dr, Ft Walton Beach, FL 32547
State ID:
L06000017371
Business type:
Florida Limited Liability Company
Managers:
Cosimo A Ricciardi (Manager), 341 Racetrack Rd, Ft Walton Beach, FL 32547 (Physical),Diane N. Siwicki Manager, inactive
Agent:
Diane Siwicki,341 Racetrack Rd SUITE A, Ft Walton Beach, FL 32547 (Physical)
EIN:
20-4395518

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