Organization
FANCY FEET PODIATRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE STANIMIROV DPM (OWNER)
(917) 930-0497
Entity
Organization
Contact information
Practice address
2123 W DR MARTIN LUTHER KING JR BLVD STE 103, TAMPA, FL 33607-6545
(813) 999-1716
Mailing address
3905 W MULLEN AVE, TAMPA, FL 33609-4426
(917) 930-0497
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Enumeration date
04/03/2018
Last updated
11/10/2020
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