Healthcare Provider Details

I. General information

NPI: 1255892592
Provider Name (Legal Business Name): TAMARA Z NEMEROFF DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMARA X NEMEROFF DPM

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MILITARY TRL STE 208
JUPITER FL
33458-7040
US

IV. Provider business mailing address

15815 SHADDOCK DR STE 130
WINTER GARDEN FL
34787-5773
US

V. Phone/Fax

Practice location:
  • Phone: 561-781-5062
  • Fax: 561-516-7528
Mailing address:
  • Phone: 813-400-1140
  • Fax: 813-701-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4243
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO4243
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4243
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberPO4243
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO4243
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPO4243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: