Provider Demographics
NPI:1588189195
Name:TENDER LOVING FOOT & ANKLE CARE
Entity Type:Organization
Organization Name:TENDER LOVING FOOT & ANKLE CARE
Other - Org Name:SWFL MOBILE FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:239-841-4790
Mailing Address - Street 1:802 SW 10TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-4403
Mailing Address - Country:US
Mailing Address - Phone:239-841-4790
Mailing Address - Fax:
Practice Address - Street 1:802 SW 10TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-4403
Practice Address - Country:US
Practice Address - Phone:239-841-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOEL CHARLES RUTHERFORD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3569213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty