Healthcare Provider Details

I. General information

NPI: 1689686495
Provider Name (Legal Business Name): NADJA MARIE PIERRE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 KEYSVILLE AVE
SPRING HILL FL
34608-3516
US

IV. Provider business mailing address

5400 PINEHURST DR
SPRING HILL FL
34606-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-666-1913
  • Fax: 352-666-1903
Mailing address:
  • Phone: 352-277-5348
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: