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NPI Code Detail

MEDICARE: TOMMY STEVEN KENNEDY DPM

MEDICARE: TOMMY STEVEN KENNEDY DPM
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
1213E00000XPodiatristPO4164FL
2213E00000XPodiatrist5901400350MI

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 : 1104351956
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOMMY STEVEN KENNEDY DPM
Provider Business Mailing Address
First Line : 401 E JACKSON ST STE 2340
Second Line :
City : TAMPA
State : FL
Zip : 33602-5226
Country : US
Telephone Number : 813-751-2291
Fax Number : 813-751-2294
Provider Business Practice Location Address
First Line : 401 E JACKSON ST STE 2340
Second Line :
City : TAMPA
State : FL
Zip : 33602-5226
Country : US
Telephone Number : 813-751-2291
Fax Number : 813-751-2294
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2017
Last Update Date : 11/06/2020

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Directions to “ TOMMY STEVEN KENNEDY DPM” Practice Location

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