Provider Demographics
NPI:1093392581
Name:VERDONI, TYLER J (DPM)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:J
Last Name:VERDONI
Suffix:
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 1:15815 SHADDOCK DR STE 130
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5773
Mailing Address - Country:US
Mailing Address - Phone:407-605-2321
Mailing Address - Fax:407-671-4155
Practice Address - Street 1:5741 BEE RIDGE RD STE 490
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5062
Practice Address - Country:US
Practice Address - Phone:941-924-8777
Practice Address - Fax:941-924-5888
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4550213ES0103X
FLP04550213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery