Provider Demographics
NPI:1619082369
Name:FELDMAN, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQUARE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:14547 BRUCE B DAWNS BLVD #A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-280-7100
Practice Address - Fax:813-355-5023
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38035207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100015711OtherRR MEDICARE
FL374684400Medicaid
FL30547Y - TPAMedicare PIN
FL100015711OtherRR MEDICARE
FLD54032Medicare UPIN