Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coastal Foot & Ankle Wellness Center LLC

Organization Foot & Ankle Surgery Podiatrist · NPI 1972834760

Coastal Foot & Ankle Wellness Center LLC is a Foot & Ankle Surgery Podiatrist in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2010.

Licensed in
FL
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1740 Tree Blvd Ste 112
St Augustine, FL 32084-5720
Phone: (904) 826-1900
Fax: (904) 826-1920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence P02829 (FL)

Record details

NPI number1972834760
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Johnson — Owner · (904) 826-1900
NPI enumeratedJanuary 19, 2010
Last updated in NPPESDecember 27, 2020
Certification dateDecember 27, 2020
Mailing address1740 Tree Blvd Ste 112, St Augustine, FL 32084-5720

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