Healthcare Provider Details

I. General information

NPI: 1184936049
Provider Name (Legal Business Name): CHRISTY LEIGH SCIMECA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S MOON AVE STE 101
BRANDON FL
33511-5716
US

IV. Provider business mailing address

4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US

V. Phone/Fax

Practice location:
  • Phone: 813-796-5617
  • Fax: 833-382-1902
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number13312377-0501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3943
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: