Provider Demographics
NPI:1487336483
Name:PODIATRY NURSING HOME ASSOCIATES
Entity type:Organization
Organization Name:PODIATRY NURSING HOME ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHEEHY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:813-872-8939
Mailing Address - Street 1:4144 N ARMENIA AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4144 N ARMENIA AVE STE 230
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6447
Practice Address - Country:US
Practice Address - Phone:813-872-8939
Practice Address - Fax:813-872-8649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty