Provider Demographics
NPI:1750454740
Name:SAVIDAKIS, JOHN JR (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SAVIDAKIS
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 VALLEY VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-4463
Mailing Address - Country:US
Mailing Address - Phone:727-796-1490
Mailing Address - Fax:727-797-5611
Practice Address - Street 1:2701 PARK DR STE 6
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1021
Practice Address - Country:US
Practice Address - Phone:727-796-1490
Practice Address - Fax:727-797-5611
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOOOO2430213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480027243OtherRAILROAD MEDICARE
FL390339700Medicaid
FLU54997Medicare UPIN
FL390339700Medicaid