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General NPI Number Information
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NPI Number | 1225154370
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Entity Type | Individual
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Provider Name | DOMINIC EDWARD DIPIERRO D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 2300 E COUNTY ROAD 540A
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City | LAKELAND
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State | FL
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Zip | 33813-3825
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Country | US
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Telephone | 863-680-7214
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Fax | 866-264-8519
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Provider Business Mailing Address
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Address Line | 1600 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3019
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Country | US
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Telephone | 863-680-7000
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Fax | 866-264-8519
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07001057A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36003446
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3821
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License Number State | FL
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