Provider Demographics
NPI:1649614975
Name:TENENBOYM, DENNIS ALEXANDER (DPM)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ALEXANDER
Last Name:TENENBOYM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7800 66TH ST N STE 207
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2101
Mailing Address - Country:US
Mailing Address - Phone:727-399-8186
Mailing Address - Fax:727-440-8186
Practice Address - Street 1:7800 66TH ST N STE 207
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781
Practice Address - Country:US
Practice Address - Phone:727-399-7167
Practice Address - Fax:727-440-8186
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3935213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist