Provider Demographics
NPI:1255892592
Name:NEMEROFF, TAMARA Z (DPM)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:Z
Last Name:NEMEROFF
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:X
Other - Last Name:NEMEROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
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:813-400-1140
Mailing Address - Fax:813-701-9132
Practice Address - Street 1:1025 MILITARY TRL STE 208
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7040
Practice Address - Country:US
Practice Address - Phone:561-781-5062
Practice Address - Fax:561-516-7528
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4243213ES0103X, 213ES0131X, 213E00000X, 213EP0504X, 213EP1101X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3511982OtherCIGNA ID
FL6977504OtherAETNA ID
15455034OtherCAQH ID
FL113228700Medicaid
FLI5YE3OtherBCBS