MEDICARE: CATHERINE STANIMIROV DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	N005558-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154332021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE STANIMIROV DPM

Provider Business Mailing Address
First Line	:	1001 N MACDILL AVE STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-5152
Country	:	US
Telephone Number	:	917-930-0497
Fax Number	:

Provider Business Practice Location Address
First Line	:	2123 W DR MARTIN LUTHER KING JR BLVD STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6545
Country	:	US
Telephone Number	:	813-999-1716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/10/2020

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Directions to “ CATHERINE STANIMIROV DPM” Practice Location

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