MEDICARE: TENDER LOVING FOOT & ANKLE CARE

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
1	213E00000X	Podiatrist	PO3569	FL

General Provider Information

NPI Number	:	1588189195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER LOVING FOOT & ANKLE CARE

Provider Business Mailing Address
First Line	:	802 SW 10TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-4403
Country	:	US
Telephone Number	:	239-841-4790
Fax Number	:

Provider Business Practice Location Address
First Line	:	802 SW 10TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-4403
Country	:	US
Telephone Number	:	239-841-4790
Fax Number	:

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. JOEL CHARLES RUTHERFORD
Credential	:	DPM
Telephone Number	:	239-841-4790

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	07/21/2022

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