Healthcare Provider Details

I. General information

NPI: 1184373987
Provider Name (Legal Business Name): NEVIN JOSEPH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 BEE RIDGE RD STE 490
SARASOTA FL
34233-5062
US

IV. Provider business mailing address

5741 BEE RIDGE RD STE 490
SARASOTA FL
34233-5062
US

V. Phone/Fax

Practice location:
  • Phone: 941-924-8777
  • Fax: 407-671-4155
Mailing address:
  • Phone: 941-924-8777
  • Fax: 407-671-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4678
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4678
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: