Provider Demographics
NPI:1184936049
Name:SCIMECA, CHRISTY LEIGH (DPM)
Entity type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:LEIGH
Last Name:SCIMECA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4101 CHARLOTTE AVE STE F185
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 S MOON AVE STE 101
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5716
Practice Address - Country:US
Practice Address - Phone:813-796-5617
Practice Address - Fax:833-382-1902
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13312377-0501213E00000X
FLPO3943213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT4127388Medicaid