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NPI Code Detail

MEDICARE: DR. SALEENA RUTH NIEHAUS D.P.M.

MEDICARE:  DR. SALEENA RUTH NIEHAUS  D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery PodiatristPO4193FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053717181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SALEENA RUTH NIEHAUS D.P.M.
Provider Business Mailing Address
First Line : 508 S HABANA AVE STE 230
Second Line :
City : TAMPA
State : FL
Zip : 33609-4161
Country : US
Telephone Number : 330-581-1781
Fax Number :
Provider Business Practice Location Address
First Line : 508 S HABANA AVE STE 230
Second Line :
City : TAMPA
State : FL
Zip : 33609-4161
Country : US
Telephone Number : 813-877-6636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2014
Last Update Date : 10/23/2024

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