Provider Demographics
NPI:1356868228
Name:PRECISION FOOT AND ANKLE PA
Entity Type:Organization
Organization Name:PRECISION FOOT AND ANKLE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/FOOT AND ANKLE SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:TENENBOYM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-399-7167
Mailing Address - Street 1:7800 66TH ST N STE 207
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2101
Mailing Address - Country:US
Mailing Address - Phone:727-399-7167
Mailing Address - Fax:727-440-8186
Practice Address - Street 1:7800 66TH ST N STE 207
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781
Practice Address - Country:US
Practice Address - Phone:727-399-7167
Practice Address - Fax:727-440-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3935261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1649614975OtherPROVIDER NPI